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 SANTIANO
NAME EXTENSION (JR., SR) N/A
FIRST NAME MAY

MIDDLE NAME DE PANO

3. DATE OF BIRTH
(mm/dd/yyyy) 1/5/1973 16. CITIZENSHIP ✘ Filipino Dual Citizenship
✘ by birth by naturalization
4. PLACE OF BIRTH BINAN,LAGUNA If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female

6 CIVIL STATUS Single Married 17. RESIDENTIAL ADDRESS PUROK LAKATAN

✘ Widowed Separated House/Block/Lot No. Street
CONCEPCION WEST
Other/s:
Subdivision/Village Barangay
ZARAGOZA NUEVA ECIJA
7. HEIGHT (m) 1.49
City/Municipality Province
8. WEIGHT (kg) 47 ZIP CODE 3110
18. PERMANENT ADDRESS PUROK LAKATAN
9. BLOOD TYPE "O"
House/Block/Lot No. Street
CONCEPCION WEST
10. GSIS ID NO. 73050101053
Subdivision/Village Barangay
ZARAGOZA NUEVA ECIJA
11. PAG-IBIG ID NO. 03061311801
City/Municipality Province
12. PHILHEALTH NO. 07-000104877-3 ZIP CODE 3110

13. SSS NO. N/A 19. TELEPHONE NO. N/A

14. TIN NO. 239-595-478-00 20. MOBILE NO. 09071346452

15. AGENCY EMPLOYEE NO.
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME
FIRST NAME
4168770 21. E-MAIL ADDRESS (if any) may.santiano@deped.gov.ph
SANTIANO 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) N/A MICAH MEI D. SANTIANO
RONALDO 9/11/1995

MIDDLE NAME BENICO JEZREEL RONALDO D. SANTIANO 11/30/1997

OCCUPATION FARMING JOSHUA RONALDO D. SANTIANO 05/19/2000

EMPLOYER/BUSINESS NAME N/A JONAH D. SANTIANO 06/25/2005

BUSINESS ADDRESS N/A MARIA CIELO D. SANTIANO 06/25/2007

TELEPHONE NO. N/A

24. FATHER'S SURNAME DE PANO

NAME EXTENSION (JR., SR) N/A
FIRST NAME ROMULO

MIDDLE NAME ANGELES

25. MOTHER'S MAIDEN NAME

SURNAME MARCAIDA
M
FIRST NAME GLORIA

MIDDLE NAME ERNEA (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

HIGHEST
NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE LEVEL/ SCHOLARSHIP/
26. PERIOD OF ATTENDANCE YEAR
UNITS ACADEMIC
LEVEL (Write in full) EARNED
GRADUATED
HONORS
(Write in full) (if not RECEIVED
From To
graduated)
GRADUAT FIFTH
ELEMENTARY ZARAGOZA CENTRAL SCHOOL PRIMARY EDUCATION 1990-1981 1985-1986 1986
ED HONOR
VOCATIONAL /
SECONDARY ZARAGOZA PROVINCIAL SCHOOL HIGH SCHOOL 1986-1987 1989-1990 GRADUATED 1990 N/A

N/A N/A N/A N/A N/A N/A N/A

COLLEGE TRADE
GRADUAT
CENTRAL LUZON STATE UNIVERSITY BACHELOR OF ELEMENTARY EDUCATION 1990-1991 1993-1994 1994 N/A
COURSE ED
MANUEL V. GALLEGO FOUNDATION
GRADUATE STUDIES
COLLEGES
MASTER OF EDUCATION 1999-2000 2003-2004 42 UNITS 2004 N/A
(Continue on separate sheet if necessary)
SIGNATURE DATE 01/15/2024

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 EACHERS(LET) 78.8 05/26/1994 MALOLOS,BULACAN 0489734 11/13/1998

(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/ SERVICE
POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY
(mm/dd/yyyy) MONTHLY PAY GRADE (if STATUS OF
(Write in full/Do SALARY
applicable)& STEP
APPOINTMENT
(Format "00-0")/
not abbreviate) (Write in full/Do not abbreviate) INCREMENT
From To
(Y/ N)
1/1/2024 PRESENT TEACHER III DEPARTMENT OF EDUCATION PERMANENT YES

1/1/2023 12/31/2023 TEACHER III DEPARTMENT OF EDUCATION PERMANENT YES

1/1/2022 12/31/2022 TEACHER III DEPARTMENT OF EDUCATION 28028.00 13-5 PERMANENT YES

1/1/2021 12/31/2021 TEACHER III DEPARTMENT OF EDUCATION 28028.00 13-5 PERMANENT YES

1/1/2020 12/31/2020 TEACHER III DEPARTMENT OF EDUCATION 28028.00 13-5 PERMANENT YES

1/1/2019 12/31/2019 TEACHER III DEPARTMENT OF EDUCATION 28028.00 13-5 PERMANENT YES

1/1/2018 12/31/2018 TEACHER III DEPARTMENT OF EDUCATION 25091.00 13-4 PERMANENT YES

1/1/2017 12/31/2017 TEACHER III DEPARTMENT OF EDUCATION 24047.00 13-4 PERMANENT YES

1/1/2016 12/31/2016 TEACHER III DEPARTMENT OF EDUCATION 23045.00 13-4 PERMANENT YES

8/2/2015 12/31/2015 TEACHER III DEPARTMENT OF EDUCATION 22086.00 13-4 PERMANENT YES

8/2/2012 8/1/2015 TEACHER III DEPARTMENT OF EDUCATION 21867.00 13-3 PERMANENT YES

1/6/2012 1/8/2012 TEACHER III DEPARTMENT OF EDUCATION 21650.00 13-2 PERMANENT YES

1/6/2011 05/31/2012 TEACHER III DEPARTMENT OF EDUCATION 19980.00 13-2 PERMANENT YES

06/24/2010 05/31/2011 TEACHER III DEPARTMENT OF EDUCATION 18166.00 13-2 PERMANENT YES

2/8/2009 06/23/2010 TEACHER III DEPARTMENT OF EDUCATION 16424.00 13-2 PERMANENT YES

1/7/2009 1/8/2009 TEACHER III DEPARTMENT OF EDUCATION 16101.00 13-1 PERMANENT YES

1/7/2008 06/30/2009 TEACHER III DEPARTMENT OF EDUCATION 13512.00 12-1 PERMANENT YES

2/8/2006 06/30/2007 TEACHER III DEPARTMENT OF EDUCATION 12284.00 12-1 PERMANENT YES

4/7/2005 1/8/2006 TEACHER II DEPARTMENT OF EDUCATION 11167.00 12-1 PERMANENT YES

3/6/2002 2/7/2002 TEACHER I DEPARTMENT OF EDUCATION 10535.00 11-1 PERMANENT YES

7/1/2002 02/14/2002 TEACHER I DEPARTMENT OF EDUCATION 9939.00 10-1 SUBSTITUTE YES

11/21/2001 12/21/2001 TEACHER I DEPARTMENT OF EDUCATION 9939.00 10-0 SUBSTITUTE YES

06/19/2001 08/16/2001 TEACHER I DEPARTMENT OF EDUCATION 9939.00 10-0 SUBSTITUTE YES

06/26/2000 03/31/2001 TEACHER I DEPARTMENT OF EDUCATION 9466.00 10-0 SUBSTITUTE YES

11/24/1999 01/16/2000 TEACHER I DEPARTMENT OF EDUCATION 9466.00 10-0 SUBSTITUTE YES

1/9/1999 10/30/1999 TEACHER I DEPARTMENT OF EDUCATION 8605.00 10-0 SUBSTITUTE YES

06/19/1999 08/1419/99 TEACHER I DEPARTMENT OF EDUCATION 8605.00 10-0 SUBSTITUTE YES

11/19/1998 11/1/1999 TEACHER I DEPARTMENT OF EDUCATION 8605.00 10-0 SUBSTITUTE YES

02/23/1998 03/24/1998 TEACHER I DEPARTMENT OF EDUCATION 8605.00 10-0 SUBSTITUTE YES

4/6/1997 07/28/1997 TEACHER I DEPARTMENT OF EDUCATION 7309.00 10-0 SUBSTITUTE YES
(Continue on separate sheet if necessary)

SIGNATURE DATE 01/15/2024

CS FORM 212 (Revised 2017), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
NAME & ADDRESS OF ORGANIZATION INCLUSIVE DATES
29. (Write in
full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To

N/A N/A N/A N/A N/A

(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
TITLE OF LEARNING AND DEVELOPMENT ATTENDANCE Type of LD
30. ( Managerial/ CONDUCTED/ SPONSORED BY
INTERVENTIONS/TRAINING PROGRAMS NUMBER OF HOURS
Supervisory/
(mm/dd/yyyy) (Write in full)
(Write in full) From To Technical/etc)
VIRTUAL IN SERVICE TRAINING FOR PUBLIC
03/15/2021 03/19/2021 40.0 TECHNICAL DEPED
TEACHERS
VIRTUAL IN-SERVICE TRAINING FOR TEACHERS 08/30/2021 3/9/2021 40.0 TECHNICAL DEPED
MUSEUM MATTER:DIGITAL MUSEUM AS ONLINE
RESOURCE FOR LEARNING,TEACHING AND 09/18/2020 09/18/2020 2.0 TECHNICAL
VIBAL
ADVOCACY
SCHOOL BASED ENTRY AND ASSESSMENT TOOL
09/17/2020 09/17/2020 2.0 TECHNICAL
FOR LEARNING KEY STAGE VIBAL
DIAGNOSING NUMERACY FOUNDATIONAL SKILLS IN
10/9/2020 10/9/2020 2.0 TECHNICAL VIBAL
EARLY GRADES
EARLY LITERACY DIAGNOSIS:IDENTIFYING
8/9/2020 8/9/2020 2.0 TECHNICAL
STRENGHTS VIBAL
DIAGNOSING STUDENTS COMPREHENSION AND
09/07,2020 09/07,2020 2.0 TECHNICAL
INFORMATIONAL AND NARRATIVE TEXT VIBAL
PREPARING THE MINDSET OF TEACHERS
09/19/2020 09/19/2020 2.0 TECHNICAL VIBAL
TOWARDS DISTANT EDUCATION
LEARNING MATHEMATICS AT HOME KEYPOINTS IN
09/14/2020 09/14/2020 2.0 TECHNICAL
PARENTS ENGAGEMENT IN THE NEW NORMAL VIBAL
CORRECTING AND REMEDIATING VOCABULARY
09/13/2020 09/13/2020 2.0 TECHNICAL
DEFICIT VIBAL
PAGKAMALIKHAIN SA LABAS NG APAT NA SULOK
12/8/2020 12/8/2020 2.0 TECHNICAL VIBAL
NG SCREEN
PRACTICAL WAYS TO PROMOTE AND ENHANCE
LEANING AT HOME FROM LIMITED PROLIFIC 7/8/2020 7/8/2020 2.0 TECHNICAL VIBAL
TECHNOLOGY USE AT HOME

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN
NON-ACADEMIC DISTINCTIONS / RECOGNITION ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES 33.
(Write in full) (Write in
full)
GOVERNMENT SERVICE INSURANCE
COOKING N//A
SYSTEM
SINGING ZARAGOZA TEACHERS CLUB

(Continue on separate sheet if necessary)

SIGNATURE DATE 01/15/2024
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:
________________________________
N/A

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: N/A
________________________________
Status of Case/s:

36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or
YES ✘ NO
regulation by any court or tribunal?
If YES, give details:
________________________________
N/A
________________________________
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 If YES, give details:
phased out (abolition) in the public or private sector? ________________________________
N/A
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year YES ✘ NO
(except Barangay election)? N/A
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before YES ✘ NO
the last election to promote/actively campaign for a national or local candidate? If YES, give details: N/A
39. Have you acquired the status of an immigrant or permanent resident of another country?
YES ✘ NO
If YES, give details (country):
N/A
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
a.
items:
Are you a member of any indigenous group? YES ✘ NO
If YES, please specify: N/A
b. Are you a person with disability? YES ✘ NO
If YES, please specify ID No: N/A
c. Are you a solo parent? YES ✘ NO
If YES, please specify ID No: N/A

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

NAME ADDRESS TEL. NO.

ID picture taken within
DEL PILAR the last 6 months
LOVELLA S. BELMONTE EAST,ZARAGOZA,NUEVA ECIJA
N/A 3.5 cm. X 4.5 cm
(passport size)

CEASAR C. LOPEZ CABANATUAN CITY N/A With full and handwritten

name tag and signature over
SAN ISIDRO,ZARAGOZA,NUEVA printed name
CELERINA M. LEONCIO ECIJA
9434003763
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 PHOTO
filing of 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 LICENSE

ID/License/Passport No.: 04899734

Signature (Sign inside the box)
01/15/2024
Date/Place of Issuance: 11/13/1998/SAMPALOC,MANILA
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