Pds LIZA 2 1

CS FORM 212 (Revised 2005)
PERSONAL DATA SHEET

Print legibly. Mark appropriate boxes
with "
1. CS ID No.
" and use separate sheet if necessary.
(to be filled up by CSC)
I. PERSONAL INFORMATION
2. SURNAME
FIRST NAME
|I
MIDDLE NAME
I |
N | O
| Z
| U | M
N | G
A |
| A
|
| C
| O
|
| T
O | D
|
|
|
|
|
|
|
|
|
|
|
Male
6. SEX
7. CIVIL STATUS
Single
Married
8. CITIZENSHIP
FILIPINO
9. HEIGHT (m)
5'1"
|
|
3|. NAME EXTENSION (e.g. Jr., Sr.)
Phase 4 Blk 7 Lot 41,Southville 3, NHA, Poblacion,

Muntinlupa City
KALAMANSIG,SULTAN KUDARAT
5. PLACE OF BIRTH
16. RESIDENTIAL ADDRESS
11/15/1976
4. DATE OF BIRTH (mm/dd/yyyy)
Fem ale
ZIP CODE
Widowed
Separated
Others, specify __________
1176
NONE
17. TELEPHONE NO.

18. PERMANENT ADDRESS
Phase 4 Blk 7 Lot 41,Southville 3, NHA, Poblacion,

Muntinlupa City
10. WEIGHT (kg)
63 KG.
11. BLOOD TYPE
B+
19. TELEPHONE NO.
NONE
12. GSIS ID NO.
NONE
20. E-MAIL ADDRESS (if any)
lizabinongo@ymail.com
13. PAG-IBIG ID NO.
NONE
21. CELLPHONE NO. (if any)
0939-633-6252
14. PHILHEALTH NO.
19-090077834-5
22. AGENCY EMPLOYEE NO.
15. SSS NO.
09-1686246-8
23. TIN
ZIP CODE
1176
227-253-304
II. FAMILY BACKGROUND

24. SPOUSE'S SURNAME
BINONGO
25. NAME OF CHILD (Write full name and list all)
DATE OF BIRTH (mm/dd/yyyy)
FIRST NAME
GILDO
GLYZA MAE L. BINONGO
05/09/2006
MIDDLE NAME
CUALTEROS
GERALD L. BINONGO
07/18/2008
OCCUPATION
ELECTRICAL BUILDING MAINTENANCE
EMPLOYER/BUS. NAME
JARDINE EQUIPMENT CONTROL
BUSINESS ADDRESS
JM Compound 2901 Faraday St. cor. OSMENA, Highway,

Makati City
0918-4328212
TELEPHONE NO.
(Continue on separate sheet if necessary)
LUMACTOD
FIRST NAME
FERNANDO
MIDDLE NAME
VILLACORTE
26. FATHER'S SURNAME
27. MOTHER'S MAIDEN NAME

SURNAME
BENENOSO
FIRST NAME
DIONIDA
MIDDLE NAME
DURA
III. EDUCATIONAL BACKGROUND

28.
NAME OF SCHOOL
LEVEL
(Write in
full)
DEGREE
COURSE
(Write in full)
YEAR GRADUATED
(if
graduated)
MANGAGOY CENTRAL ELEM.SCHOOL

Bislig City
TABON M.ESTRELLA NATIONAL HS Bislig
City
ELEMENTARY
SECONDARY
VOCATIONAL /
TRADE
HIGHEST GRADE/
LEVEL/
UNITS EARNED
(if not graduated)
INCLUSIVE DATES OF
ATTENDANCE
From
To
SCHOLARSHIP/
ACADEMIC HONORS
RECEIVED
PRIMARY
1990
N/A
1984
1990
N/A
SECONDARY
1994
N/A
1990
1994
N/A
N/A
N/A
N/A
N/A
N/A
2001
N/A
1997
2001
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
PHILIPPINE NORMAL UNIVERSITY

MANILA
BACHELOR OF
SECONDARY EDUC.
Major in HOME ECO.
N/A
N/A
COURSE
COLLEGE
GRADUATE STUDIES

Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY

29.
CAREER SERVICE/ RA 1080 (BOARD/ BAR)
UNDER SPECIAL LAWS/ CES/ CSEE
RATING
LICENSURE EXAM FOR TEACHERS
75%
DATE OF
EXAMINATION /
CONFERMENT
LICENSE (if applicable)

PLACE OF EXAMINATION / CONFERMENT
08/26/2001
NUMBER
NCR (LYCEUM)
1132627
DATE OF
RELEASE
03/12/13
V. WORK EXPERIENCE (Include private employment. Start from your current work)
30.
INCLUSIVE DATES
(mm/dd/yyyy)
From
DEPARTMENT / AGENCY / OFFICE / COMPANY

(Write in full)
To
May 15,2013
PRESENT
06/20/2012
03/31/2013
TEACHER 1
06/03/2011 03/31/2012
06/05/2001
POSITION TITLE
03/31/2006
TLE TEACHER
(Grade 7)
TLE TEACHER
(First-Fourth year)
TLE TEACHER
(First-Fourth year)
(Write in full)
GOV'T
SERVICE
MONTHLY
SALARY
STATUS OF
APPOINTMENT
(Yes / No)
MUNTINLUPA NATIONAL HIGH SCHOOL NHAAnnex
18,549.00
PEDRO E. DIAZ HIGHSCHOOL
18,9000.00
HOLY INFANT ACADEMY

SAINT VINCENT DE PAUL COLLEGE
SALARY
GRADE & STEP
INCREMENT
(Format "00-0")
PERMANENT
YES
SUBSTITUTE
YES
6,000.00
REGULAR
NO
8,000.00
CONTRACTUAL
NO

CS FORM 212 (Revised 2005), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S

31.
INCLUSIVE DATES
NAME & ADDRESS OF ORGANIZATION

(Write in full)
(mm/dd/yyyy)
N/A
From
To
N/A
N/A
NUMBER
OF HOURS
POSITION / NATURE OF WORK
N/A
N/A
VII. TRAINING PROGRAMS (Start from the most recent training.)

INCLUSIVE DATES OF ATTENDANCE
32.
TITLE OF SEMINAR/CONFERENCE/WORKSHOP/SHORT COURSES (Write in

full)
Trainer of First Place Winner in Experimental Cookery
NUMBER
OF HOURS
(mm/dd/yyyy)
CONDUCTED/ SPONSORED BY
(Write in full)
From
To
1/21/2015
1/22/2015
11 hours
De La Salle Zobel
2/26/2015
2/27/2015
11 hours
Pasay City West High School
during 2015 Division Technolympics Skills Competition
Trainer of 3rd Place Winner in Experimental Cookery

during 2015 Regional Technolympics Skills Competition
NC2 Cookery
11/25/14
11/25/14
11 hours
Deped Muntinlupa
Mentoring the Mentor
10/28/2014
10/30/2014
27 hours
Deped Muntinlupa
Naturally-Grown Vegetable Production
10/ 4/14 (AM)
10/4/14 (PM)
10 hours
Deped Muntinlupa/ Deped NCR
June 4,2014
June 4,2014
4 hours
Deped Muntinlupa
Bar Tending NC2/Food and Beverage Services NC2/ Housekeeping

NC2
08/17/2013
11/08/2013
336
Deped Muntinlupa
NC2 Commercial Cooking
04/01/2013
05/15/2013
Division-Orientation of TLE Grade 9 Teachers
336
MCTI Muntinlupa City
VIII. OTHER INFORMATION

33.
SPECIAL SKILLS / HOBBIES:
34.
NON-ACADEMIC DISTINCTIONS / RECOGNITION:

(Write in full)
35.
MEMBERSHIP IN
ASSOCIATION/ORGANIZATION
(Write in
full)
N/A
N/A
N/A
N/A
COMPUTER LITERATE(MS WORD,EXCEL,POWERPOINT)
COOKING,BAKING,HANDICRAFT MAKING

36.
Are you related by consanguinity or affinity to any of the following :
a.
Within the third degree (for National Government Employees):

appointing authority, recommending authority, chief of office/bureau/department or person who
has immediate supervision over you in the Office, Bureau or Department where you will be
appointed?
YES
NO
If YES, give details: _____________________________________
_____________________________________
_____________________________________
b.
Within the fourth degree (for Local Government Employees):

appointing authority or recommending authority where you will be appointed?
YES
NO
If YES, give details: _____________________________________
_____________________________________
_____________________________________
37
a. Have you ever been formally charged?
YES
NO
If YES, give details: ________________________________

________________________________
YES
b. Have you ever been guilty of any administrative offense?
NO

________________________________
38.
Have you ever been convicted of any crime or violation of any law, decree, ordinance or
regulation by any court or tribunal?
39.
Have you ever been separated from the service in any of the following modes: resignation,
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract, AWOL or
phased out, in the public or private sector?
40.
YES
NO
________________________________
YES
NO

________________________________
Have you ever been a candidate in a national or local election (except Barangay election)?
YES
NO

________________________________
41.
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?
b.
Are you differently abled?
c.
Are you a solo parent?
YES
NO
If YES, please specify: ____________________
42. REFERENCES (Person not related by consanguinity or affinity to applicant / appointee)

NAME
43.
ADDRESS
TEL. NO.
Ms. Eleonor Despuig
Pedro E.Diaz High School
0906-3120082
Mr. Joaquin Basijan
Pedro E.Diaz High School
0999-4593759
I declare under oath that this Personal Data Sheet has been accomplished by me, and is a true, correct and complete
statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the Philippines.
I also authorize the agency head / authorized representative to verify / validate the contents stated herein. I trust that this
information shall remain confidential.
ID picture taken within

the last 6 months
3.5 cm. X 4.5 cm
(passport size)
Computer generated
or xerox copy of picture
is not acceptable
PHOTO
07859071
COMMUNITY TAX CERTIFICATE NO.
MUNTINLUPA CITY
ISSUED AT
SIGNATURE (Sign inside the box)
01/07/2013
March 12,2013
ISSUED ON (mm/dd/yyyy)
DATE ACCOMPLISHED
RIGHT THUMBMARK

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CS FORM 212 (Revised 2005)

PERSONAL DATA SHEET

" and use separate sheet if necessary.

(to be filled up by CSC)

3|. NAME EXTENSION (e.g. Jr., Sr.)

Phase 4 Blk 7 Lot 41,Southville 3, NHA, Poblacion,

16. RESIDENTIAL ADDRESS

4. DATE OF BIRTH (mm/dd/yyyy)

17. TELEPHONE NO.

Phase 4 Blk 7 Lot 41,Southville 3, NHA, Poblacion,

10. WEIGHT (kg)

11. BLOOD TYPE

19. TELEPHONE NO.

12. GSIS ID NO.

20. E-MAIL ADDRESS (if any)

13. PAG-IBIG ID NO.

21. CELLPHONE NO. (if any)

14. PHILHEALTH NO.

22. AGENCY EMPLOYEE NO.

15. SSS NO.

II. FAMILY BACKGROUND

25. NAME OF CHILD (Write full name and list all)

DATE OF BIRTH (mm/dd/yyyy)

GLYZA MAE L. BINONGO

ELECTRICAL BUILDING MAINTENANCE

JARDINE EQUIPMENT CONTROL

JM Compound 2901 Faraday St. cor. OSMENA, Highway,

(Continue on separate sheet if necessary)

26. FATHER'S SURNAME

27. MOTHER'S MAIDEN NAME

(Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

MANGAGOY CENTRAL ELEM.SCHOOL

PHILIPPINE NORMAL UNIVERSITY

(Continue on separate sheet if necessary)

IV. CIVIL SERVICE ELIGIBILITY

LICENSURE EXAM FOR TEACHERS

LICENSE (if applicable)

(Continue on separate sheet if necessary)

DEPARTMENT / AGENCY / OFFICE / COMPANY

MUNTINLUPA NATIONAL HIGH SCHOOL NHAAnnex

PEDRO E. DIAZ HIGHSCHOOL

HOLY INFANT ACADEMY

(Continue on separate sheet if necessary)

VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S

NAME & ADDRESS OF ORGANIZATION

POSITION / NATURE OF WORK

(Continue on separate sheet if necessary)

VII. TRAINING PROGRAMS (Start from the most recent training.)

TITLE OF SEMINAR/CONFERENCE/WORKSHOP/SHORT COURSES (Write in

Trainer of First Place Winner in Experimental Cookery

Pasay City West High School

during 2015 Division Technolympics Skills Competition

Trainer of 3rd Place Winner in Experimental Cookery

Mentoring the Mentor

Naturally-Grown Vegetable Production

10/ 4/14 (AM)

Deped Muntinlupa/ Deped NCR

Bar Tending NC2/Food and Beverage Services NC2/ Housekeeping

NC2 Commercial Cooking

Division-Orientation of TLE Grade 9 Teachers

MCTI Muntinlupa City

(Continue on separate sheet if necessary)