Technical Education and Skills Development Authority

Pangasiwaan sa Edukasyong Teknikal at Pagpapaunlad ng Kasanayan

NMIS FORM 01A

( For TPIS )

MANPOWER PROFILE FORM

In accomplishing this form, entries in Italicized letters are optional while the rest are mandatory or required information.

ID PICTURE (2x 2 size)

1.2. NMIS Entry Date:

1. To be accomplished by TESDA
RIGHT THUMBMARK
1.1.

NMIS Manpower Code:

2. Manpower Profile
2.1.

Signature

Name: Mailing Address:

DE GUZMAN
Last

MONA LUISA
First

CHAN
Middle

2.2.

BLOCK 1 LOT 24
Number, Street

BRGY. BLOCK 22, PHASE 2

Barangay Province Region

MANDURRIAO
District

ILOILO CITY
City/Municipality

REGION 6

5000
Zip Code P.O. Box No.

2.3. Sex

2.4. Civi l Stat us

Contact Number/s
0928 505 9771 (033) 321-0639

2.5. Employment Type

2.6. Employment Status

Male Female

Single Married Window/er Separated

Employed Self-employed Unemployed Undefined

Casual Contractual Job Order Temporary

Probationary Regular Permanent

If Student Trainee/OJT

3. Personal Information
3.1. Birthdate: 3.2. Birth Place: 3.3. Citizenship: 3.4. Religion: 3.5. Ethnicity: 3.6. Disability: 08 AUGUST 1979 3.7. Height: 3.8. Weight: 3.9. Blood Type: 3.10. SSS No.: 3.11. GSIS No.: 3.13. Distinguishing Marks: 3.12. TIN No.:

4. Educational Background
4.1. School
ASIAN INSTITUTE OF TOURISM, UP, DILIMAN COLLEGE OF BUSINESS ADMINISTRATION, UP DILIMAN

4.2. Educational Level

UNDERGRADUATE

4.3. School Year 1996 2003

OCT 1999

4.4. Degree BS TOURISM MBA 5.4 Monthly Salary

4.5. Minor

4.6. Major

4.7 Units Earned

4.8. Honors Received

5. WORKING EXPERIENCE ( For Trainers, mandatory field 5.5)

5.1. Name of Company 5.2 Position
Program Head/ Faculty
PROGRAM COORDINATOR

POST GRADUATE

2005 5.3

Inclusive Dates
JUNE 2006

5.5 Occupation Type (Teaching; Non-Teaching; Industrial Experience)

5.6 Status of Appointment No. of Yrs. Working Exp.

JBLFMU-Molo, INC.
UP COLLEGE OF LAW, IDR & PDR OFFICES ASIAN INSTITUTE OF TOURISM, UP DILIMAN KALAYAAN RESIDENCE HALL, UP DILIMAN

present
MAY 2006 MAY 2006 APRIL 2005

LECTURER
RESIDENT ASSITANT

JUNE 2005 JUNE 2005 JUNE 2004

29,000 15,000 10,000 5,000

TEACHING NON-TEACHING TEACHING NON-TEACHING

FULL TIME
PERMANENT, PART-TIME PERMANENT, PART-TIME

PART TIME

3.00 1.50 1.50 1.00

NAVITAIRE INTERNATIONAL, LLC.

DEPARTMENT OF TOURISM, KALAW

TRAINING OFFICER/SRA

OJT

JAN 2000 MAR 1999

JULY 2003 JUNE 1999

28,000

INDUSTRIAL EXPERIENCE INDUSTRIAL EXPERIENCE

PERMANENT, FULL TIME

PART-TIME

3.50 0.25

(For more information, indicate on a separate sheet)

6. Training/Seminars Attended
6.1 Title 6.2 Venue 6.3 Inclusive Dates 6.4 *Certificate Received 6.5 # of Hours 6.6 Training Base 6.7 Category 6.8 Conducted By 6.9 Proficiency

(For more information, indicate on a separate sheet) * Certificate Received

A c P Certificate of Attendance Certificate of Competencies Certificate of Proficiency T

SSkills Training Certificate Training Certificate

Training Base LLocal F Foreign

Category TTrade Skills Upgrading Program N Non-Trade Upgrading Program M Training Management

Proficiency BBeginner I Intermediate A Advanced

7. Licenses/Examinations Passed
7.1. Title 7.2 Year Taken 7.3 Examination Venue 7.4 Rating 7.5 Remarks 7.6 Expiry Date

(For more information, indicate on a separate sheet)

8. Skills Specialization
8.1 Industry Sector To be filled up by NMIS 8.2 Trade Area 8.3 Occupation 8.4 Trade Level To be filled up by NMIS 8.5 Competency To be filled up by NMIS 8.6 Specialization Description

(For more information, indicate on a separate sheet)

9. Family Background
9.1. Spouses Name: 9.2. Educational Attainment: 9.5. Fathers Name: RAMON S. DE GUZMAN 9.6. Educational Attainment: BS BIO, MS ZOO, LLb. 9.9. Mothers Name: LUCITA C. DE GUZMAN 9.10. Educational Attainment: BS ChE, MS ChE, PhD (ChE) 9.13. Name of Guardian: 9.14. Educational Attainment 9.17. Dependents 9.18. Age 9.3 Occupation: 9.4 Ave. Monthly Income: 9.7. Occupation: 9.8. Ave. Monthly Income: 9.11. Occupation: 9.12. Ave. Monthly Income: 9.15. Occupation: 9.16. Ave. Monthly Income: Dependents Age

(For more information, indicate on a separate sheet)