Professional Documents
Culture Documents
CS Form No. 212 Personal Data Sheet Revised Long
CS Form No. 212 Personal Data Sheet Revised Long
212
Revised 2017
I. PERSONAL INFORMATION
2. SURNAME GONZALES
NAME EXTENSION (JR., SR) N/A
FIRST NAME AIZAH-MARIE
15. AGENCY EMPLOYEE NO. 5404908 21. E-MAIL ADDRESS (if any) ziamariegonzales@gmail.com aizahmarie.gonzales@deped.gov.ph
SURNAME CELORICO
VALEDICTORIA
ELEMENTARY OLD ALION ELEMENTARY SCHOOL ELEMENTARY 3/6/1991 03/31/1997 GRADUATED 1997 N
SECONDARY /
VOCATIONAL MNHS-CABCABEN SECONDARY 2/6/1997 03/31/2001 GRADUATED 2001 RANK 7
TRADE SKOLAR NG
BAYAN/1YR
COURSE
COLLEGE PUP-BATAAN BRANCH BACHELOR IN ELEMENTARY EDUCATION 06/13/2015 04/16/2019 GRADUATED 2019 ACT-CIS
SCHOLAR
MASTER OF ARTS IN EDUCATIONAL
GRADUATE STUDIES BPSU GRADUATE SCHOOL
MANAGEMENT
08/25/2021 8/1/2022 GRADUATED N/A N/A
LICENSED PROFESSIONAL TEACHER 82.4 09/29/2019 PAMPANGA NATIONAL HIGH SCHOOL 1865961 02/16/2020
10/8/2022 9/5/2023 TEACHER 1 MT. VIEW ELEMENTARY SCHOOL 27000.00 11-1 PERMANENT YES
01/17/2022 9/8/2022 TEACHER 1 IPAG ELEMENTARY SCHOOL 25439.00 11-1 PERMANENT YES
09/29/2021 11/24/2021 TEACHER 1 CABCABEN ELEMENTARY SCHOOL 23877.00 11-1 SUBSTITUTE YES
06/16/2021 10/1/2021 TEACHER 1 SAINT FRANCIS ELEMENTARY SCHOOL 23877.00 11-1 SUBSTITUTE YES
02/19/2021 05/30/2021 TEACHER 1 CABCABEN ELEMENTARY SCHOOL 23877.00 11-1 SUBSTITUTE YES
10/11/2020 11/2/2021 TEACHER 1 SISIMAN ELEMENTARY SCHOOL 22316.00 11-1 SUBSTITUTE YES
ASIA PACIFIC COLLEGE OF ADVANCED
2/5/2019 03/31/2020 PRESCHOOL TEACHER 10000.00 PROBATIONARY NO
STUDIES
CPD 3-DAY ONLINE INTERNATIONAL TRAINING VIRTUAL WORKSHOP ON READING 06/17/2022 06/19/2022 24.0 TECHNICAL SDO-BATAAN
EDUC-ACTION, MUSIC AND ARTS: INTEGRATION IN ELEMENTARY TEACHING 08/18/2017 08/18/2017 8.0 TECHNICAL PUP-BATAAN
DIVISION SEMINAR-WORKSHOP IN SPORTS OFFICIATING AND COACHING 6/10/2016 8/10/2016 24.0 TECHNICAL DIVISION OF BATAAN
SINGING TEACHER VOLUNTEER IN NATIONAL READING CAMP 2023 CARD MUTUAL BENEFIT ASSOCIATION, INC.
MAPSTEA
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
YES ✘ NO
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? End of contract
________________________________
________________________________
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?
YES ✘ NO
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? YES ✘ NO
If YES, please specify ID No:
JULIET B. BATALLONES BASECO, MARIVELES, BATAAN (0919) 095 2613 ID picture taken within
the last 6 months
4.5 cm. X 3.5 cm
AILEEN R. NUŇEZ CABCABEN, MARIVELES, BATAAN (0966) 7697 239 (passport size)
MARICEL A. HUALDE CABCABEN, MARIVELES, BATAAN (0929) 8427 557 Computer generated
or photocopied picture
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and 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.
SUBSCRIBED AND SWORN to before me this MARCH 11, 2024 , affiant exhibiting his/her validly issued government ID as indicated above.
ELDA E. AFABLE
Person Administering Oath