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 GUIANI
N/A
FIRST NAME SAGUIRA

MIDDLE NAME ABAS

3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) ✘ Filipino Dual Citizenship
6/21/1995 by
by naturalization
birth
4. PLACE OF BIRTH PIKIT, NORTH COTABATO If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female

6 CIVIL STATUS ✘ Single Married 17. RESIDENTIAL ADDRESS N/A N/A

Widowed House/Block/Lot No. Street

Separate
N/A LIMBO
Other/s: d
Subdivision/Village Barangay
SULTAN KUDARAT MAGUINDANAO DEL NORTE
7. HEIGHT (m) 1.6256
City/Municipality Province
8. WEIGHT (kg) 49 ZIP CODE 9605

18. PERMANENT ADDRESS N/A N/A

9. BLOOD TYPE "O"
House/Block/Lot No. Street
N/A LIMBO
10. GSIS ID NO. N/A
Subdivision/Village Barangay
SULTAN KUDARAT MAGUINDANAO DEL NORTE
11. PAG-IBIG ID NO. 1212-0656-6594
City/Municipality Province

12. PHILHEALTH NO. 170504244361 ZIP CODE 9605

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

14. TIN NO. N/A 20. MOBILE NO. 09650970041

15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) saguiraguiani1@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) N/A
FIRST NAME N/A N/A
N/A
MIDDLE NAME N/A N/A
N/A
OCCUPATION N/A N/A
N/A
EMPLOYER/BUSINESS NAME N/A N/A
N/A
BUSINESS ADDRESS N/A N/A
N/A
TELEPHONE NO. N/A N/A
N/A
24. FATHER'S SURNAME GUIANI N/A
NAME EXTENSION (JR., SR) N/A
FIRST NAME GUIALUDIN N/A
N/A
MIDDLE NAME GUIAPLOS N/A
N/A
25. MOTHER'S MAIDEN NAME N/A
N/A
SURNAME ABAS N/A
N/A
FIRST NAME EMBABAI N/A

MIDDLE NAME KULOD (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 NULING CENTRAL ELEMENTARY SCHOOL ELEMENTARY GRADUATE 6/24/1905 6/30/1905 GRADUATED 2008 N/A

SECONDARY /
VOCATIONAL SULTAN KUDARAT NATIONAL HIGH SCHOOL SECONDARY GRADUATE 6/30/1905 7/4/1905 GRADUATED 2012 N/A

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

TRADE
COURSE
COLLEGE COTABATO CITY STATE POLYTECHNIC COLLEGE BACHELOR OF SCIENCE IN SOCIAL WORK 7/4/1905 7/8/1905 GRADUATED 2016 N/A

GRADUATE STUDIES N/A N/A N/A N/A N/A N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE May 28, 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
SEPTEMBER 18, 19, 20, 12/13/2023-
RA 1080 (REGISTERED SOCIAL WORKER) 0.7 2023
KORONADAL CITY 0040442
06/21/2026

(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)

5/15/2016 6/16/2016 GOVERNMENT INTERN CENTER FOR THE HANDICAPPED 4000.00 N/A MOA YES

DEPARTMENT OF SOCIAL WELFARE AND

11/14/2019 2/28/2020 AREA SUPERVISOR
DEVELOPMENT
20000.00 N/A MOA YES

3/15/2022 6/16/2022 GOVERNMENT INTERN MINISTRY OF LABOR AND EMPLOYMENT 4950.00 N/A MOA YES

8/7/2023 PRESENT SOCIAL WORK INSTRUCTOR SANDIGAN COLLEGE INCORPORATED 5000.00 N/A PART TIME NO

(Continue on separate sheet if necessary)

SIGNATURE DATE MAY 26, 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

PHILIPPINE ASSOCIATION OF SOCIAL WORKERS INCORPORATED 8/29/2015 8/29/2015 7 HOURS VOLUNTEER

CAS CARE PROGRAM RELIEF DISTRIBUTION, FEEDING AND PSYCHOSOCIAL ACTIVITIES 9/15/2015 9/15/2015 7 HOURS FACILITATOR

CCSPC GUIDANCE AND TESTING CENTER (JOB READINESS SEMINAR FOR GRADUATING STUDENTS 3/17/2016 3/18/2016 7 HOURS ORGANIZER

(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

SEMINAR ON SERVICES RENDERED BY DSWD IN AUTONOMOUS REGION IN MUSLIM MINDANAO 10/15/2014 10/15/2014 6 HOURS N/A NORHAINA C. ABDUL AZIZ, RSW, MSSW

SEMINAR ON CICL WITH THE THEME "THE ROLE OF FAMILY, GOVERNMENT AND SOCIAL WORKER
IN THE PREVENTION OF JUVENILE DELIQUENCY
8/8/2015 8/8/2015 6 HOURS N/A
EMAN L. PANONDI, RSW
SEMINAR ON PROJECT PROPOSAL PREPARATION WITH A THEME SOCIAL WORK STUDENT
LEADING TOWARDS EXECELLENT COMMUNITY SERVICE DELEVERY
8/16/2014 8/16/2014 6 HOURS N/A
MARWISA S. SALAM, RSW, MTSW

GENDER SENSITIVITY AND AWARENESS SEMINAR 3/29/2016 3/29/2016 6 HOURS N/A

COTABATO CITY STATE POLYTECHNIC COLLEGE

SEMINAR WORKSHOP ON PROTOCOL IN HANDLING CHILDREN IN CONFLICT WITH THE LAW 9/21/2015 9/21/2015 6 HOURS N/A
CHELO M. BUNAO, RSW, MTSW

SEMINAR ON R.A 9262: VIOLENCE AGAINST WOMEN AND THEIR CHILDREN 9/16/2015 9/16/2015 6 HOURS N/A
CHELO M. BUNAO, RSW, MTSW

SEMINAR ON DOMESTIC AND INTERNATIONAL ADOPTATION POLICY 9/14/2015 9/14/2015 6 HOURS N/A
CHELO M. BUNAO, RSW, MTSW

SEMINAR ON UNDERSTANDING DISASTER RISK REDUCTION AND MANAGEMENT 8/31/2015 8/31/2015 6 HOURS N/A
EMAN L. PANONDI, RSW

SEMINAR ON CAMP MANAGEMENT: SOCIAL WORKERS RESPONSE IN DISASTER SITUATION 8/26/2016 8/26/2016 6 HOURS N/A CHELO M. BUNAO, RSW,MTSW

SEMINAR WORKSHOP ON FIRE SAFETY AND PREVENTION 8/25/2015 8/25/2015 6 HOURS N/A SR.INSP. NESTOR D. BADE, BFP

COMPLETED JEEP ACCELERATE DURING 2 A. Y 2014-2015 YEAR 2 OF JOB ENABLING PROFECIENCY

(JEEP) PROGRAM
6/21/2013 3/31/2015 2 YEARS N/A COTABATO CITY STATE POLYTECHNIC COLLEGE

SEMINAR ON ROLES AND FUNCTIONS OF MEDICAL

SOCIAL WORKER
9/21/2015 9/21/2015 6 HOURS N/A
CHELO M. BUNAO, RSW, MTSW
OJT-FIELD INSTRUCTION AND PRACTICE 1
WORKING WITH INDIVIDUALS AND FAMILIES
1/5/2015 400 HOURS N/A
FAUDZIA LUMENDA, RSW
OJT-FIELD INSTRUCTION AND PRACTICE 1
WORKING WITH GROUPS
06/15/1015 8/31/2015

OJT-FIELD INSTRUCTION AND PRACTICE 1

WORKING WITH COMMUNITIES
11/2/2015 3/25/2016

(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)

(Continue on separate sheet if necessary)

SIGNATURE DATE
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
b. within the fourth degree (for Local Government Unit - Career Employees)? YES
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
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? ________________________________
________________________________
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
4.5 cm. X 3.5 cm
(passport size)

Computer generated
or photocopied picture
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:

ID/License/Passport No.:
Signature (Sign inside the box)

Date/Place of Issuance:
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