PHRMO-APPT FORM NO.

1 (Revised, September 2021)

Republic of the Philippines
PROVINCE OF BUKIDNON
Malaybalay City

PROVINCIAL HUMAN RESOURCE MANAGEMENT OFFICE

JOB APPLICATION FORM
APPLICANT'S PROFILE
LASTNAME: Ebare AGE:
FIRSTNAME: VG Clark GENDER:
Leswe NAME EXT.: NICKNAME: PHOTO HERE
MIDDLE NAME: CLICK HERE TO INSERT
(Leave blank, if NO Middle Name) CELL NUMBER:
PHOTO AND FOLLOW
ADDRESS: p-10 Natidasan Casisang Malaybalay City CIVIL STATUS Married INSTRUCTIONS AT
ARE YOU PRESENTLY EMPLOYED WITH THE PGB? NO NO. OF YRS IN THE PGB THE RIGHT →
PRESENT POSITION? NO. OF YRS IN THE POSITION

ARE YOU A MEMBER OF AN INDIGENOUS GROUP? NO SPECIFY:

ARE YOU A DIFFERENTLY-ABLED PERSON? NO SPECIFY:
QUALIFICATIONS
(Provide first the information required in this page before filling out the additional information in Page 2)
NAME OF SCHOOL/ COLLEGE/ UNIVERSITY RELEVANT COURSE/DEGREE YEAR GRADUATED/
LEVEL
(May be Abbreviated) (May be Abbreviated) Units Earned, if not Grad
EDUCATION

GRADUATE
STUDIES

COLLEGE BUKIDNON STATE UNIVERSITY BS-ELECTRONICS

VOCATIONAL
SECONDARY BUKIDNON NATIONAL HIGH SCHOOL
PRIMARY SUMPONG ELEMENTARY SCHOOL
START FROM THE LATEST JOB EXPERIENCE
POSITION TITLE POSITION TITLE
NAME OF OFFICE NAME OF OFFICE
STATUS STATUS
NAME & POSITION NAME & POSITION OF
OF SUPERVISOR SUPERVISOR

INCLUSIVE DATE INCLUSIVE DATE

SALARY per month SALARY per month

JOB DESCRIPTION/FUNCTIONS (Required) JOB DESCRIPTION/FUNCTIONS (Required)

*
RELEVANT EXPERIENCE

ELIGIBILITY EMPLOYMENT AWARD PERFORMANCE RATING

NAME OF ELIGIBILITY NAME OF AWARD RATING PERIOD
NUM. RATING
RATING, IF ANY: DATE ISSUED: ADJ. RATING

TRAININGS ATTENDED
TITLE OF RELEVANT TRAININGS/SEMINARS DATE/S NO. OF HRS TYPE OF TRAINING
 CERTIFICATION

I HEREBY CERTIFY that all the information provided by me on this VG Clark L. Ebare
application form are true, correct and complete.
Signature over printed name
ADDITIONAL SHEET FOR EXPERIENCE AND TRAININGS ATTENDED IS PROVIDED IN PAGE 2
Instructions to insert PHOTO

1. Scan your Passport Size Photo

and save in the computer
2. Click the Box
3. Click "Insert" Tab
4. Select "Pictures" under
Illustrations Menu
5. Go to the location where your
photo was saved, Select the Photo
and Click Insert
6. Resize to fit in the Box
7. Done.

OTHER OPTION

Print the accomplished form and

manually paste your Passport Size
Photo.
AFFIX SIGNATURE HERE
 ADDITIONAL SHEET FOR WORK EXPERIENCE AND TRAININGS ATTENDED
(You may insert additional rows, if necessary)
START FROM THE LATEST JOB EXPERIENCE
POSITION TITLE POSITION TITLE
NAME OF OFFICE NAME OF OFFICE
STATUS STATUS
NAME & POSITION NAME & POSITION OF
OF SUPERVISOR SUPERVISOR

INCLUSIVE DATE INCLUSIVE DATE

SALARY per month SALARY per month

JOB DESCRIPTION/FUNCTIONS (Required) JOB DESCRIPTION/FUNCTIONS (Required)

RELEVANT EXPERIENCE

START FROM THE LATEST JOB EXPERIENCE

POSITION TITLE POSITION TITLE
NAME OF OFFICE NAME OF OFFICE
STATUS STATUS
NAME & POSITION NAME & POSITION OF
OF SUPERVISOR SUPERVISOR

INCLUSIVE DATE INCLUSIVE DATE

SALARY per month SALARY per month

JOB DESCRIPTION/FUNCTIONS (Required) JOB DESCRIPTION/FUNCTIONS (Required)

RELEVANT EXPERIENCE

TRAININGS ATTENDED FOR THE LAST FIVE (5) YEARS

TITLE OF RELEVANT TRAININGS/SEMINARS DATE/S NO. OF HRS TYPE OF TRAINING
* Types of Training: Core, Technical, Supervisory or Manageriail