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 BELDAD
NAME EXTENSION (JR., SR)
FIRST NAME ARON ALFRED

MIDDLE NAME TOLOSA

3. DATE OF BIRTH
7/26/1994 16. CITIZENSHIP
(mm/dd/yyyy) ✘ Filipino Dual Citizenship
by birth by naturalization
4. PLACE OF BIRTH SAN NICOLAS IRIGA CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Female
✘ Male
17. RESIDENTIAL ADDRESS ZONE 6 SITIO PASTO
6 CIVIL STATUS ✘ Single Married
House/Block/Lot No. Street
Widowed Separate TAGBONG
Other/s: d Subdivision/Village Barangay
PILI CAMARINES SUR
7. HEIGHT (m) 1.52 M
City/Municipality Province
8. WEIGHT (kg) 63 KG ZIP CODE

18. PERMANENT ADDRESS ZONE 6 SITIO PASTO

9. BLOOD TYPE A+
House/Block/Lot No. Street
TAGBONG
10. GSIS ID NO. N/A
Subdivision/Village Barangay

11. PAG-IBIG ID NO. 1211-7146-6103 PILI CAMARINES SUR

City/Municipality Province

12. PHILHEALTH NO. 102514380624 ZIP CODE 4418

13. SSS NO. 05-1312211-6 19. TELEPHONE NO.

14. TIN NO. 487-535-893-00 20. MOBILE NO. 09957322202

15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any) aronalfredbeldad@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR)
FIRST NAME

MIDDLE NAME

OCCUPATION

EMPLOYER/BUSINESS NAME

BUSINESS ADDRESS

TELEPHONE NO.

24. FATHER'S SURNAME BELDAD

NAME EXTENSION (JR., SR)
FIRST NAME DOMINGO

MIDDLE NAME CEDERIA

25. MOTHER'S MAIDEN NAME

SURNAME TOLOSA

FIRST NAME MAGDALENA

MIDDLE NAME PACIS (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
(Write in full) HONORS
full) (if not graduated) RECEIVED
From To

ELEMENTARY SAN JOSE SOUTH ELEMENTARY SCHOOL Elementary 2006

SECONDARY /
VOCATIONAL PILI CAPITAL COLLEGE INC. Sencondary 2010

N/A

TRADE
CENTRAL BICOL STATE UNIVERSITY OF
COURSE
COLLEGE
AGRICULTURE
BSE- Filipino 2016

GRADUATE STUDIES N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE January 22, 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

LICENSURE EXAMINATION FOR TEACHER 80.2 3/1/2017 LEGAZPI CITY, ALBAY 1555636 7/26/2024

DRIVER'S LICENSE 7/26/2022 PILI, CAMARINES SUR E07-18-001413 7/26/2032

(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.
GOV'T
28. INCLUSIVE DATES SALARY/ JOB/ PAY 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
(Format "00-0")/
abbreviate) full/Do not abbreviate) INCREMENT
From To
(Y/ N)
UNIVERSIDAD DE STA. ISABEL PILI
7/1/2019 06/31/2023 COORDINATOR- FILIPINO P 1, 500.00 REGULAR
CAMPUS
UNIVERSIDAD DE STA. ISABEL PILI
7/1/2019 06/31/2023 CAT COMMANDANT P 1,000.00 REGULAR
CAMPUS
1/1/2021 5/16/2021 Cooperating Teacher/ Instructional Coach CBSUA - USI Pili Campus N/A

1/1/2022 4/28/2023 Cooperating Teacher/ Instructional Coach CBSUA - USI Pili Campus N/A

Organization of Private Schools in Camarines

2/8/2023 5/26/2023 COACH (Volleyball) N/A REGULAR
Sur inc.
UNIVERSIDAD DE STA. ISABEL PILI
8/1/2022 5/31/2022 FILIPINO Coordinator N/A REGULAR
CAMPUS

(Continue on separate sheet if necessary)

SIGNATURE DATE January 22, 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
BICOL FEDERATION OF ACTIVE AND RESERVE PMT COMMANDANTS AND
7/1/2019 PRESENT MEMBER/ BOARD OF JUDGES AND SECRETARIAT
INNTRUCTORS LEAGUE

THE FRATERNAL ORDER OF EAGLES PHILIPPINES 7/1/2019 PRESENT MEMBER

SAMAHAN NG MGA TAGAPAGTAGUYOD NG WIKANG FILIPINO (CBSUA) 7/1/2013 4/30/2016 MEMBER

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
INCLUSIVE DATES OF
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ( Managerial/ CONDUCTED/ SPONSORED BY
NUMBER OF HOURS
(Write in full) (mm/dd/yyyy) Supervisory/ (Write in full)
Technical/etc)
From To

BACS Assembly - CEAP region V 7/13/2018 7/14/2018 16.0 Attendee Bikol Association of Catholic Schools

PEAC JHS InSeT Feedbacking 8/5/2021 8/5/2021 2.0 Speaker USI- Pili Campus

ARALinks Leadership Academy 7/28/2017 7/30/2017 24.0 Attendee Phoenix Educational Foundation Inc.

Catholic Education Association of Caceres and

8th CEACAL Teachers Congress 1/3/2018 1/3/2018 8.0 Attendee
Libmanan

Educational Leadership Development Academy 4/1/2019 4/13/2019 80.0 Attendee Phoenix Educational Foundation Inc.

Phoenix ARALinks Faculty Training Program 7/10/2019 7/10/2019 4.0 Attendee Phoenix Educational Foundation Inc.

National Achievement Test 6.0 Proctor Department of Education

Research (Presentation and Defese) 10/2/2017 10/20/2017 Panel USI- Pili Campus

USI Pili Intramural Skills Olympics 5/4/2021 5/4/2021 6.0 Judge USI- Pili Campus

Military Parade Competition 8/1/2023 5/31/2023 Commandant USI- Pili Campus

Decentralized Coaching and Officiating Training 11/24/2023 11/26/2023 Attendee Department of Education Camarines Sur

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

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

PLAYING GUITAR

AGRICULTURAL FARMING (HYDROPONICS) HYDROPONIC GROWERS PHILIPPINES

CAT and MAPEH DRILLS AND COMMANDS
Outstanding CAT Facilitator in Bicol Region (9th) BFARPCIL, Inc.
TRAINING
CAT and MAPEH DRILLS AND COMMANDS
Outstanding MAPEH Facilitator in Bicol Region (5th) BFARPCIL, Inc.
TRAINING

(Continue on separate sheet if necessary)

SIGNATURE DATE January 22, 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
by any court or tribunal? YES ✘ NO
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? Resigned for employment
________________________________ in DepEd
________________________________
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:

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

NAME ADDRESS TEL. NO.

ID picture taken within
the last 6 months
Mr. Angelo C. Baguio Lapurisima, Pili, Camarines Sur 9287411780 4.5 cm. X 3.5 cm
(passport size)

Mr. Jimmy P. Sertan San Jose, Pili, Camarines Sur 9399251809

Computer generated
or photocopied picture
Ems Sarte Palestina, Pili, Camarines Sur 9106350904 is not acceptable

42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and
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

ID/License/Passport No.: 1555636

Signature (Sign inside the box)

Date/Place of Issuance: 08/03/2017/ PRC LEGAZPI 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