Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
212
Revised 2017
I. PERSONAL INFORMATION
2. SURNAME SIBAL
NAME EXTENSION (JR., SR)
FIRST NAME JOHN EXEQUIEL
15. AGENCY EMPLOYEE NO. 2833 21. E-MAIL ADDRESS (if any) jesibal0629@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME NONE 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR)
FIRST NAME NONE AL GREGORY ADAM TABERNA SIBAL 1/29/2014
OCCUPATION NONE
SURNAME SIBAL
ELEMENTARY TUGUEGARAO WEST CENTRAL SCHOOL ELEMENTARY 6/11/2001 3/9/2007 GRADUATED 2007 NONE
SECONDARY /
VOCATIONAL SAN JACINTO SEMINARY SECONDARY 6/18/2007 3/21/2011 GRADUATED 2011 NONE
NONE NONE
TRADE
B.S. BUSINESS ADMINISTRATION MAJOR IN
COURSE
COLLEGE CAGAYAN STATE UNIVERSITY
MANAGEMENT ACCOUNTING
### 6/15/2016 GRADUATED 2016 NONE
20021505077
CAREER SERVICE PROFESSIONAL 83.6 6/15/2015 TUGUEGARAO CITY
70301
CONTRACT
9/4/2017 PRESENT CLERK CAGAYAN VALLEY MEDICAL CENTER 7000.00 N/A
OF SERVICE
CONTRACT
3/1/2016 2/17/2017 BOOK-KEEPER THOM SOYA FOOD PRODUCTS 6000.00 N/A
OF SERVICE
CAGAYAN STATE UNIVERSITY - COLLEGE OF BUSINESS, ENTREPRENEURSHIP
3/9/2015 5/22/2015 ON-THE-JOB-TRAINEE AND ACCOUNTANCY N/A N/A OJT
CONTRACT
12/9/2013 1/23/2014 CALL SERVICE REPRESENTATIVE JOLIBEE FOODS CORPORATION 4000-4500 N/A
OF SERVICE
(Continue on separate sheet if necessary)
Date of
Validity
GOV'T
SERVICE
(Y/
N)
NO
NO
NO
NO
arate sheet if necessary)
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
NONE
LUSOG ISIP SEMINAR, MENTAL HEALTH CELEBRATION 10/21/2017 10/21/2017 8.0 TECHNICAL CAGAYAN VALLEY MEDICAL CENTER
b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘
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? ________________________________
RESIGNED IN JOLIBEE DUE TO PATERN
________________________________
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:
SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated
✘ NO
✘ NO
If YES, give details (country):
✘ NO
✘ NO
✘ NO
Computer generated
or photocopied picture
is not acceptable
PHOTO
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