Professional Documents
Culture Documents
Application Letter
Application Letter
Dear Madam,
Greetings.
Good day!
I wrote this letter to show my interest on the vacant position in your institution. I heard
that you are in need of a skilled and competent worker. I am very willing to be a part of
your team at your institution because I know that being with your team is the best way to
train myself on how to showcase the best of my abilities and to show how I work with
patience, determination, and love, as well as how to deal with the attitudes and values
of different people.
Please consider my letter. I am willing to wait for any follow up from you regarding my
application. I am also looking forward to it. Enclosed to this is my resume containing my
other information specifically my personal background. And if you have any questions
regarding this letter you can message me on my number 09683732635.
Sincerely yours,
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 ARCEGA
NAME EXTENSION (JR., SR)
FIRST NAME ROMAR RICO
MIDDLE NAME
OCCUPATION
EMPLOYER/BUSINESS NAME
BUSINESS ADDRESS
TELEPHONE NO.
SURNAME HORNILLA
SECONDARY BATANGAS NATIONAL HIGH SCHOOL High School 2010 2014 GRADUATE 2014
VOCATIONAL /
TESDA- Regional Training Center-CALABARZO VOCATIONAL / Pipefitting (NC II) 2016 2016 GRADUATE 2016
COLLEGE Golden Gate Colleges Bachelor of Science in Nursing 2018 2022 GRADUATE 2022 EBD-SCHOLARSHIP
GRADUATE STUDIES
SIGNATURE DATE
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 Date of
(If Applicable) NUMBER
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT Validity
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
INCLUSIVE DATES SALARY/ JOB/ PAY SERVICE
28. POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY GRADE (if
(mm/dd/yyyy) MONTHLY STATUS OF
(Write in full/Do not (Write in applicable)& STEP
SALARY (Format "00-0")/ APPOINTMENT
abbreviate) full/Do not abbreviate)
From To INCREMENT
SIGNATURE DATE
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
CONQUERING HORIZONS: POSSIBILITIES AND GROWTH IN EMERGENCY MEDICINE De La Salle University Medical Center
8/4/2024 9/4/2024 16 HOURS
Cooking
SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 3 of 11
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:
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? 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:
SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.
2. The duration should include start and finish dates, if known, month in abbreviated
form, if known, and year in full. For the current position, use the word Present,
e.g., 1998-Present. Work experience should be listed from most recent first.
o Plan, gives and evaluates nursing care. o Documents all data concerning
patient. o Carries out doctor’s order. o Administers medications and treatment
accurately. o Reports observation to the physician. o Admits and discharges
patient and gives health teachings. o Prepares patient and assists physician in
diagnostic and therapeutic procedure.
o Performs other duties as may be assigned.
o In charged with all over independent and dependent nursing roles. o
Remembering and applying the patient’s right.