CS Form No.

212
Revised 2017

PERSONAL DATA SHEET

WARNING: Any misrepresentation made in the Personal Data Sheet and the Work Experience Sheet shall cause the filing of administrative/criminal case/s against the person
concerned.
READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM.
Print legibly. Tick appropriate boxes ( ) and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE. 1. CS ID No. (Do not fill up. For CSC use only)

I. PERSONAL INFORMATION
2. SURNAME BERNALES
NAME EXTENSION (JR., SR)
FIRST NAME FRANKLIN

MIDDLE NAME BELDAD

3. DATE OF BIRTH
(mm/dd/yyyy) 3/23/1991 16. CITIZENSHIP

4. PLACE OF BIRTH QUEZON CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX ✘ FEMALE
MALE
17. RESIDENTIAL ADDRESS
6 CIVIL STATUS ✘ SINGLE MARRIED
House/Block/Lot No. Street
WIDOW SEPARATED GUINDAPUAN
OTHER/S: Subdivision/Village Barangay
SAN JORGE SAMAR
7. HEIGHT (m) 1.62
City/Municipality Province
8. WEIGHT (kg) 81 ZIP CODE 6707

18. PERMANENT ADDRESS

9. BLOOD TYPE O+
House/Block/Lot No. Street
GUINDAPUAN
10. GSIS ID NO. 2005309617
Subdivision/Village Barangay
SAN JORGE SAMAR
11. PAG-IBIG ID NO. 121031392750
City/Municipality Province

12. PHILHEALTH NO. 02-050508005-0 ZIP CODE 6707

13. SSS NO. 34-1559553-4 19. TELEPHONE NO. NONE

14. TIN NO. 707-897-921 20. MOBILE NO. 09971901142

15. AGENCY EMPLOYEE NO.
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME
FIRST NAME
1524812 21. E-MAIL ADDRESS (if any) franklin.bernales@deped.gov.ph
NONE 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) NONE

MIDDLE NAME

OCCUPATION

EMPLOYER/BUSINESS NAME

BUSINESS ADDRESS
TELEPHONE NO.

24. FATHER'S SURNAME BERNALES

NAME EXTENSION (JR., SR)
FIRST NAME FRANCISCO
MIDDLE NAME OPINION
25. MOTHER'S MAIDEN NAME

SURNAME BELDAD

FIRST NAME DELIA

MIDDLE NAME BIÑAR (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

NAME OF SCHOOL HIGHEST LEVEL/ SCHOLARSHIP/
26. PERIOD OF ATTENDANCE YEAR
BASIC EDUCATION/DEGREE/COURSE UNITS ACADEMIC
LEVEL (Write in EARNED
GRADUATED
HONORS
(Write in full)
full) (if not graduated) RECEIVED
From To

ELEMENTARY BULAO ELEMENTARY SCHOOL Elementary Education 1997 2003 N/A 2003 Salutaturian
VOCATIONAL / SAMAR STATE COLLEGE OF AGRICULTURE
SECONDARY
AND FORESTRY
Highschool 2003 2007 N/A 2007 None
NONE N/A
TRADE Best in
NORTHWEST SAMAR STATE UNIVERSITY-
COURSE
COLLEGE
SAN JORGE CAMPUS
Bachelor of Elementary Education 2012 2016 N/A 2016 Practice
Teacher
GRADUATE STUDIES Samar College Master of Arts in Education- Elementary Education 2021 2023 45 Units
(Continue on separate sheet if necessary)

SIGNATURE DATE February 8,2024

CS FORM 212 (Revised 2017), Page 1 of 4

IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF LICENSE (if applicable)
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER Date of
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity
September 25,
Board Licensure Examination for Professional Teacher 80.8 2016
Tacloban City 1524812 3/23/2024

(Continue on separate sheet if necessary)

V. WORK EXPERIENCE
(Include private employment. Start from your recent work) Description of duties should be indicated in the attached Work Experience sheet.
28. INCLUSIVE DATES SALARY/ JOB/ PAY GOV'T SERVICE
POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY GRADE (if
(mm/dd/yyyy) MONTHLY STATUS OF
(Write in full/Do not (Write in SALARY
applicable)& STEP
APPOINTMENT (Y/
(Format "00-0")/
abbreviate) full/Do not abbreviate) INCREMENT N)
From To

Depertment of Education/Division of
5/23/2023 Present Teacher 111 Samar/Gandara II District/ Gandara II Central P 31,320.00 13-1 Permanent Y
Elementary School
Depertment of Education/Division of
9/11/2017 5/22/2023 Teacher 1 Samar/Gandara II District/ Gandara II Central P 27,000.00 11-1 Permanent Y
Elementary School

(Continue on separate sheet if necessary)

SIGNATURE DATE FEBRUARY 8,2024

CS FORM 212 (Revised 2017), Page 2 of 4

VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
INCLUSIVE DATES
29. NAME & ADDRESS OF ORGANIZATION (Write in
full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To

None

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
(Start from the most recent L&D/training program and include only the relevant L&D/training taken for the last five (5) years for Division Chief/Executive/Managerial positions)
INCLUSIVE DATES OF
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS CONDUCTED/ SPONSORED BY (Write in
NUMBER OF HOURS ( Managerial/ Supervisory/
(Write in full) (mm/dd/yyyy) Technical/etc) full)

From To

District INSET 2024 1/29/2024 1/30/2024 16.0 TECHNICAL DEPED- GANDARA 2 DISTRICT

DIVISION TRAINING ON COACHING AND OFFICIATING OF SCHOOL SPORTS EVENTS 11/25/2023 12/3/2023 32.0 TECHNICAL DEPED- SAMAR DIVISION OFFICE

ORRIENTATION -TRAINING OF UNCRC AND SPECIAL LAW FOR CHILDREN 11/17/2023 11/17/2023 8.0 TECHNICAL WESADEF

THE ROLE OF LEARNING ASSESSMENT 10/1/2023 10/1/2023 4 HOURS TECHNICAL NORTHWEST SAMAR STATE UNIVERSITY

DIVISION IMPLEMENTATION OF THE LEARNING RECOVERY PROGRAM(LRP) CURRICULUM

8/31/2023 9/2/2023 24 hours TECHNICAL DEPED- SAMAR DIVISION OFFICE
MATERIALS AND CAPABILITY BUILDING FOR KTO3 TEACHERS
District Echo Training on End-of- School Year (EOSY) Using the Early Grades Reading Assessment
6/26/2023 6/26/2023 8.0 TECHNICAL DEPED- GANDARA 2 DISTRICT
( EGRA) and the Comprehensive Rapid Literacy Assessment (CRLA)

DISTRICT ECHO TRAINING-WORKSHOP ON THE ADMINISTRATION AND UTILIZATION OF THE NEW

BEGINNING READING ASSESSMENT TOOLS COMPREHENSIVE RAPID LITERACY ASSESSMENT 6/14/2022 6/16/2022 24 HOURS TECHNICAL DEPED- GANDARA 2 DISTRICT
( CRLA) AND EARLY GRADES READING ASSESSMENT ( EGRA)

DIVISION TRAINING-WORKSHOP ON THE ADMINISTRATION AND UTILIZATION OF THE NEW

BEGINNING READING ASSESSMENT TOOLS COMPREHENSIVE RAPID LITERACY ASSESSMENT 6/7/2022 6/9/2022 24 HOURS TECHNICAL DEPED- SAMAR DIVISION OFFICE
( CRLA) AND EARLY GRADES READING ASSESSMENT ( EGRA)

VIRTUAL IN-SERVICE TRAINING FOR TEACHERS 8/30/2021 9/3/2021 40 HOURS TECHNICAL DEPED- CENTRAL OFFICE

PNPKI DIGITAL CERTIFICATE OF DEPED PERSONEL IN THE FIELD OFFICE 8/25/2021 8/25/2021 8 HOURS TECHNICAL DEPED- CENTRAL OFFICE

PROTOCOLS FOR CLASSES IN THE LEARNING MODALITY EMPLOYED BY THE

4/6/2021 4/6/2021 4 HOURS TECHNICAL NORTHWEST SAMAR STATE UNIVERSITY
SCHOOL( CLASSROOM ROUTINES)

STRAND INTERFACE ON PROGRAMS AND GUIDELINES(SIPAG) 2/23/2021 2/23/2021 2 HOURS TECHNICAL DEPED- CENTRAL OFFICE

PROGRAM DIVISION VIRTUAL CAPACITY BUILDING ON THE IMPLEMENTATION OF HOMEROOM

11/20/2020 11/20/2020 8 HOURS TECHNICAL DEPED- SAMAR DIVISION OFFICE
PROGRAM
CAPACITY BUILDING FOR KINDERGARTEN TEACHERS IN HANDLING CO-CURRICULAR ACTIVITIES
10/24/2019 10/26/2019 24 HOURS TECHNICAL DEPED- SAMAR DIVISION OFFICE
AND DIVISION SLUMBER PARTY

DISTRICT ECHO ON STORYBOOK WRITING 9/12/2019 9/12/2019 8 HOURS TECHNICAL DEPED- GANDARA 2 DISTRICT

SLAC SESSION- BEGINNING READING INSTRUCTION 6/7/2019 6/7/2019 4 HOURS TECHNICAL DEPED- GANDARA II CES

SLAC SESSION- THE CONTEXUALIZATION OF LESSON EXEMPLAR 6/7/2019 6/7/2019 4 HOURS TECHNICAL DEPED- GANDARA II CES

REGIONAL DIVISION BASED TRAINING IN COACHING AND OFFICIATING OF SCHOOL SPORTS

11/28/2018 11/30/2018 24 HOURS TECHNICAL DEPED- SAMAR DIVISION OFFICE
EVENTS

DISTRICT ROLL-OUT ON PHILLIPINE STANDARDS FOR TEACHERS (PPST) AND RESULT-BASED

11/26/2018 11/28/2018 24 HOURS TECHNICAL DEPED- GANDARA 2 DISTRICT
PERFORMANCE MANAGEMENT SYSTEM (RPMS) MANUAL FOR TEACHERS

BSP-GSP SCHOOL CAMPORAL ENCAMPMENT 11/8/2018 11/10/2018 24 HOURS TECHNICAL DEPED- GANDARA II CES

DISTRICT ROLL-OUT ON INCLUSIVE EDUCATION (IE) & SPECIAL EDUCATION (SPED) 10/23/2018 10/25/2018 24 HOURS TECHNICAL DEPED- GANDARA 2 DISTRICT

PANSANGAY NA TAGISIAN NG TALINO 10/16/2018 10/16/2018 8 HOURS TECHNICAL DEPED- SAMAR DIVISION OFFICE

EXAMINER/PROCTOR IN THE DISTRICT MATHEMATICS AND SCIENCE &TECH. FAIR 2018 10/12/2018 10/12/2018 8 HOURS TECHNICAL DEPED- GANDARA 2 DISTRICT

DISTRICT ROLL-OUT IN ENHANCEMENT OF KINDERGARTEN AND GRADE 1 TEACHERS

PEDAGIGICAL SKILLS IN TEACHING BEGINNING READING AND ORIENTATION ON THE 6/15/2018 6/16/2018 16 HOURS TECHNICAL DEPED- GANDARA 2 DISTRICT
ADMINISTRATION OF THE NEW PHILIPPINE INFORMAL READING INVENTORY (PHIL-IRI)

DIVISION ROLL-OUT IN ENHANCEMENT OF KINDERGARTEN AND GRADE 1 TEACHERS

PEDAGIGICAL SKILLS IN TEACHING BEGINNING READING AND ORIENTATION ON THE 5/16/2018 5/18/2018 24 HOURS TECHNICAL DEPED- SAMAR DIVISION OFFICE
ADMINISTRATION OF THE NEW PHILIPPINE INFORMAL READING INVENTORY (PHIL-IRI)

DIVISION TRAINING WORKSHOP ON THE ENHANCEMENT OF THE DIVISION LOCAL HERITAGE

4/11/2018 4/14/2018 32 HOURS TECHNICAL DEPED- SAMAR DIVISION OFFICE
THEME MATRIX ( DLHTM) AND DIVISION CURRICULUM CONTEXUALIZATION MATRIX ( DCCM)

ORRIENTATION OF SCHOOL HEADS AND KINDERGARTEN TEACHERS ON THE UTILIZATION OF THE

2/10/2018 2/10/2018 8 HOURS TECHNICAL DEPED- SAMAR DIVISION OFFICE
NEW PHILIPPINE CHILDHOOD DEVELOPMENT CHECKLIST

JOB ORRIENTATION / TEACHER INDUCTION PROGRAM FOR THE 2017 NEWLY HIRED TEACHERS 11/6/2017 11/8/2017 24 HOURS TECHNICAL DEPED- SAMAR DIVISION OFFICE

DIVISION BASED TRAINING FOR TEACHERS AND SCHOOLS HEADS ON KINDERGARTEN

PEDAGOGIES ,CHILD CENTERED APPROACHES, DAP ELLN, AND CLASSROOM-BASED 10/29/2017 10/31/2017 24 HOURS TECHNICAL DEPED- SAMAR DIVISION OFFICE
ASSESSMENT

DIVISION TRAINING IN BASIC CAMPUS JOURNALISM AND CAMPUS PUBLICATIONS MANAGEMENT

10/12/2017 10/14/2017 24 HOURS TECHNICAL DEPED- SAMAR DIVISION OFFICE
FOR ELEMENTARY AND SECONDARY SCHOOL PAPER ADVISERS

DISTRICT ROLL-OUT TRAINING WORKSHOP ON PROJECT HI-TECH 9/24/2017 9/26/2017 24 HOURS TECHNICAL DEPED- GANDARA 2 DISTRICT

DISTRICT BASED ECHO SEMINAR WORKSHOP ON DANCE 8 CHANCE FOR ELEMENTARY /

9/23/2017 9/25/2017 24 HOURS TECHNICAL DEPED- GANDARA 2 DISTRICT
SECONDARY SCHOOL MAPEH TEACHERS AND COORDINATORS

DISTRICT ROLL-OUT TRAINING WORKSHOP ON ACTION RESEARCH 9/22/2017 9/23/2017 24 HOURS TECHNICAL DEPED- GANDARA 2 DISTRICT

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

NON-ACADEMIC DISTINCTIONS / RECOGNITION MEMBERSHIP IN ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES 32. 33.
(Write in full) (Write in full)

DISTRICT ATHLETIC MEET 2024- 1ST PLACE AS COACH VOLLEYBALL BOYS

NONE
( ELEMENTARY LEVEL) - January 5-6, 2024
2023 UNIT 2 ATHLETIC MEET- 2ND PLACE AS COACH VOLLEYBALL GIRLS
( ELEMENTARY LEVEL) - March 10-12, 2023
DISTRICT ATHLETIC MEET 2023- 1ST PLACE AS COACH VOLLEYBALL GIRLS
( ELEMENTARY LEVEL) - March 3-5, 2023
2023 NATIONAL ARTS MONTH CONTEST ( DISTRICT LEVEL)- 1ST PLACE AS COACH IN TIKTOK DANCE
CONTEST ( ELEMENTARY LEVEL)
2022 MOST OUTSTANDING KINDERGARTEN TEACHER( REGIONAL LEVEL)- December 28, 2022

2022 MOST OUTSTANDING KINDERGARTEN TEACHER( DIVISION LEVEL)- December 9,2022

2022 MOST OUTSTANDING KINDERGARTEN TEACHER( DISTRICT LEVEL)- October 2, 2022

DISTRICT COMPETITION OF STORYBOOK WRITING 2022( 1ST PLACE) - SEPETEMBER 21-23,2022

PAKARITAY 2022- Municipal Quiz Bee- 1st Place ( Winning Coach)- September 21, 2022
2021 PROJECT PAGDUAWA OF THE CURRICULUM IMPLEMENTATION DIVISION (CID)-BEST LEARNING
MATERIALS ( KINDERGARTEN LEVEL)- February 16, 2021
(Continue on separate sheet if necessary)

SIGNATURE DATE FEBRUARY 8, 2024

CS FORM 212 (Revised 2017), Page 3 of 4
 34. Are you related by consanguinity or affinity to the appointing or recommending authority, or to the
chief of bureau or office or to the person who has immediate supervision over you in the Office,
Bureau or Department where you will be apppointed,
a. within the third degree? YES ✘ NO
b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘ NO
If YES, give details:
________________________________

35. a. Have you ever been found guilty of any administrative offense?
YES ✘ NO
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court? YES ✘ NO
If YES, give details:
________________________________
Date Filed:
________________________________
Status of Case/s:

36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation NO
YES ✘
by any court or tribunal?
If YES, give details:
________________________________
________________________________
37. Have you ever been separated from the service in any of the following modes: resignation, YES ✘ NO
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract or phased If YES, give details:
out (abolition) in the public or private sector? ________________________________
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except YES ✘ NO
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last YES ✘ NO
election to promote/actively campaign for a national or local candidate? If YES, give details:
39. Have you acquired the status of an immigrant or permanent resident of another country? NO
YES ✘

If YES, give details (country):

40. Pursuant to: (a) Indigenous People's Act (RA 8371); (b) Magna Carta for Disabled Persons (RA
7277); and (c) Solo Parents Welfare Act of 2000 (RA 8972), please answer the following items:
a. Are you a member of any indigenous group? YES ✘ NO
If YES, please specify:
b. Are you a person with disability? YES ✘ NO
If YES, please specify ID No:
c. Are you a solo parent? NO
YES ✘

If YES, please specify ID No:

41. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)

NAME ADDRESS TEL. NO.

ID picture taken within
the last 6 months
WHILMA G. ORBETA GANDARA, SAMAR 9455593735 3.5 cm. X 4.5 cm
(passport size)

MARIA B. ROSALES GANDARA, SAMAR 9655295438 With full and handwritten

name tag and signature over
printed name
ZENAIDA MACHATE GANDARA, SAMAR 9958929989
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied picture
is not acceptable
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the
Philippines. I authorize the agency head/authorized representative to verify/validate the contents stated herein.
I agree that any misrepresentation made in this document and its attachments shall cause the filing of PHOTO
administrative/criminal case/s against me.

Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)

PLEASE INDICATE ID Number and Date of
Issuance
Government Issued ID: PRC

ID/License/Passport No.: 1524812

Signature (Sign inside the box)
FEBRUARY 8, 2024
Date/Place of Issuance: 01/19/2017- Tacloban City
Date Accomplished Right Thumbmark

SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.

Person Administering Oath

CS FORM 212 (Revised 2017), Page 4 of 4