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 aga
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 C

I. PERSONAL INFORMATION
2. SURNAME PANGANIBAN
NAME EXTENSION (JR., SR) NONE
FIRST NAME EUFROCINA

MIDDLE NAME TORRES

3. DATE OF BIRTH
(mm/dd/yyyy) 5/7/1956 16. CITIZENSHIP
Filipino Dual Citizenship
✘ by birth by natura
4. PLACE OF BIRTH MALOLOS If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female

Single ✘ Married 17. RESIDENTIAL ADDRESS # 172 TORRES

6 CIVIL STATUS
Widowed Separated House/Block/Lot No. Street
PANASAHAN
Other/s:
Subdivision/Village Barangay
MALOLOS BULACAN
7. HEIGHT (m) 1.70
City/Municipality Province
8. WEIGHT (kg) 68 ZIP CODE

18. PERMANENT ADDRESS # 172 TORRES

9. BLOOD TYPE O
House/Block/Lot No. Street
PANASAHAN
10. GSIS ID NO. 56250701226
Subdivision/Village Barangay
MALOLOS BULACAN
11. PAG-IBIG ID NO. 141000926060
City/Municipality Province

12. PHILHEALTH NO. 07-000038362-5 ZIP CODE 3000

13. SSS NO. NONE 19. TELEPHONE NO. 044 791 6494

14. TIN NO. 142-490-165 20. MOBILE NO. 09330248355

15. AGENCY EMPLOYEE NO. 150012-2013 21. E-MAIL ADDRESS (if any) eufrocina.panganiban@gmail.com.ph/eufrocina.panganiba

II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME PANGANIBAN 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (

NAME EXTENSION (JR., SR)

FIRST NAME JOSE NONE JONEE TORRES PANGANIBAN 12/2/19

MIDDLE NAME VILLAFUERTE JOEL TORRES PANGANIBAN 9/24/19

OCCUPATION SELF EMPL0YED JONATHAN TORRES PANGANIBAN 10/25/1

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. 447916494

24. FATHER'S SURNAME TORRES

NAME EXTENSION (JR., SR)
FIRST NAME DELFIN SR.

MIDDLE NAME JAVIER

25. MOTHER'S MAIDEN NAME

SURNAME ESPINO

FIRST NAME CONCORDIA

MIDDLE NAME SANTIAGO (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

HIGHEST
NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE LEVEL/
26. PERIOD OF ATTENDANCE YEAR
UNITS
LEVEL (Write in full) EARNED
GRADUATE
(Write in full) D
(if not
From To graduated)

ELEMENTARY MALOLOS ELEMENTARY SCHOOL PRIMARY EDUCATION 1963 1969 GRADUATED 1969

SECONDARY REGINA CARMELI COLLEGE HIGH SCHOOL 1971 1975 GRADUATED 1975
VOCATIONAL /

N O N E
TRADE
BACHELOR OF SCIENCE MAJOR IN
COURSE
COLLEGE FAR EASTERN UNIVERSITY
CHEMISTRY
1975 1979 GRADUATED 1979

MASTER OF ARTS IN EDUCATIONAL

GRADUATE STUDIES GREENVILLE COLLEGE
MANAGEMENT
2010 2012 GARDUATED 2012
(Continue on separate sheet if necessary)

SIGNATURE DATE APRIL 28,2017

CS FORM 212 (Revised 201
 DATA SHEET
k Experience Sheet shall cause the filing of administrative/criminal case/s against the

DS) BEFORE ACCOMPLISHING THE PDS FORM.

(Do not fill up. For CSC use only)

NAME EXTENSION (JR., SR) NONE

Dual Citizenship

by naturalization

Pls. indicate country:

TORRES
Street
PANASAHAN
Barangay
BULACAN
Province

TORRES
Street
PANASAHAN
Barangay
BULACAN
Province

3000

044 791 6494

09330248355

eufrocina.panganiban@gmail.com.ph/eufrocina.panganiban@deped.gov.ph

DATE OF BIRTH (mm/dd/yyyy)

12/2/1981

9/24/1983

10/25/1989

(Continue on separate sheet if necessary)

SCHOLARSHIP/
ACADEMIC
HONORS
RECEIVED

NONE

NONE
 NONE

NONE
arate sheet if necessary)

APRIL 28,2017
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 ap
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT

CAREER SERVICE 82% 8/30/1980 MALOLOS N.A.

RA 1080 75.2 11/28/1982 SAN FERNANDO, PAMPANGA 13968

(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.
28. INCLUSIVE DATES SALARY/ JOB/ PAY
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

MARCELO H. DEL PILAR NATIONAL

01/01/2017 PRESENT MASTER TEACHER II 39,685.00 19-2 PERMANENT
HIGH SCHOOL
MARCELO H. DEL PILAR NATIONAL
611/18/2016 12/31/2016 MASTER TEACHER II 36,857.00 19-2 PERMANENT
HIGH SCHOOL
MARCELO H. DEL PILAR NATIONAL
01/01/2016 11/17/2016 MASTER TEACHER II 36,409.00 19-1 PERMANENT
HIGH SCHOOL
MARCELO H. DEL PILAR NATIONAL
11/18/13 12/31/2015 MASTER TEACHER II 33,859.00 19-1 PERMANENT
HIGH SCHOOL
MARCELO H. DEL PILAR NATIONAL
6/01/12 11/17/13 MASTER TEACHER I 31,351.00 18-1 PERMANENT
HIGH SCHOOL
MARCELO H. DEL PILAR NATIONAL
06/06/11 05/31/12 MASTER TEACHER I 28,305.00 18-1 PERMANENT
HIGH SCHOOL
MARCELO H. DEL PILAR NATIONAL
06/01/11 06/05/11 TEACHER 1 20,050.00 11-8 PERMANENT
HIGH SCHOOL
MARCELO H. DEL PILAR NATIONAL
06/24/2010 05/31/2011 TEACHER 1 17,519.00 11-8 PERMANENT
HIGH SCHOOL
MARCELO H. DEL PILAR NATIONAL
07/01/2009 06/23/2008 TEACHER 1 16,335.00 10-8 PERMANENT
HIGH SCHOOL
MARCELO H. DEL PILAR NATIONAL
07/01/2008 06/03/2009 TEACHER 1 14,297.00 10-8 PERMANENT
HIGH SCHOOL
MARCELO H. DEL PILAR NATIONAL
07/01/2007 06/30/2008 TEACHER 1 12,997.00 10-8 PERMANENT
HIGH SCHOOL
MARCELO H. DEL PILAR NATIONAL
07/01/2001 06/30/2007 TEACHER 1 11,815.00 10-8 PERMANENT
HIGH SCHOOL
01/01/2000 06/30/2001 TEACHER 1 MARCELO H. DEL PILAR HIGH SCHOOL 11,252.00 10-8 PERMANENT

11/01/1997 12/31/1999 TEACHER 1 MARCELO H. DEL PILAR HIGH SCHOOL 10,230.00 10-8 PERMANENT

01/01/1991 10/31/1997 TEACHER 1 MARCELO H. DEL PILAR HIGH SCHOOL 8,233.00 10-8 PERMANENT

01/01/1996 12/31/1996 TEACHER 1 MARCELO H. DEL PILAR HIGH SCHOOL 6,236.00 10-8 PERMANENT

01/01/1995 12/31/1995 TEACHER I MARCELO H. DEL PILAR HIGH SCHOOL 4,975.00 10-3 PERMANENT

01/01/1994 12/31/1994 TEACHER I MARCELO H. DEL PILAR HIGH SCHOOL 3,975.00 10-3 PERMANENT
01/01/1990 12/31/1993 TEACHER I MARCELO H. DEL PILAR HIGH SCHOOL 3,175.00 10-3 PERMANENT
07/01/1989 12/31/1989 TEACHER I MARCELO H. DEL PILAR HIGH SCHOOL 3,102.00 10-1 PERMANENT

01/10/1986 06/30/1986 SEC. TEACHER 3 MARCELO H. DEL PILAR HIGH SCHOOL 1,096.00 PERMANENT

01/10/1985 12/03/1985 SEC. TEACHER 3 MARCELO H. DEL PILAR HIGH SCHOOL 1053 PERMANENT
05/01/1984 12/03/1985 SEC. TEACHER 3 MARCELO H. DEL PILAR HIGH SCHOOL 957.00 PERMANENT
06/17/1983 04/30/1984 SEC. TEACHER 3 MARCELO H. DEL PILAR HIGH SCHOOL 870.00 PERMANENT

07/06/1981 06/16/1983 SEC. TEACHER 3 MARCELO H. DEL PILAR HIGH SCHOOL 736.00 PROVISIONAL

06/16/1980 03/28/1981 SEC. TEACHER 3 MARCELO H. DEL PILAR HIGH SCHOOL 546.00 TEMPORARY
01/14/1980 03/13/1980 SEC. TEACHER 3 MARCELO H. DEL PILAR HIGH SCHOOL 546.00 TEMPORARY
06/28/1979 10/31/1979 SEC. TEACHER 3 MARCELO H. DEL PILAR HIGH SCHOOL 546.00 TEMPORARY
(Continue on separate sheet if necessary)

SIGNATURE DATE
CS FORM 212 (Revised 201
 LICENSE (if applicable)

Date of
Validity

N.A.

5/7/2017

parate sheet if necessary)

GOV'T
SERVICE

(Y/
N)
YES

YES

YES

YES

YES

YES

YES

YES

YES

YES

YES

YES

YES

YES

YES

YES

YES

YES
YES
YES

YES

YES
YES
 YES

YES

YES
YES
YES
parate sheet if necessary)

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 NUMBER OF
(Write in full) HOURS POSITION / NATURE OF W
(mm/dd/yyyy)
From To

NONE N/A N/A N/A N/A

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
(Start from the most recent L&D/training program and include only the relevant L&D/training taken for the last five (5) years for Division Chief/Executive/Managerial positions)
INCLUSIVE DATES OF
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING NUMBER OF ( Managerial/ CONDUCTED/ SPONSORE
PROGRAMS (Write in full) HOURS Supervisory/
(mm/dd/yyyy)
Technical/etc)
From To
MARCELO H. DEL PIL
TEACHING WITH TECHNOLOGY 2017 3/30/2017 8 TECHNICAL
SCHOOL
MARCELO H. DEL PIL
DIVISION WIDE FIRST AID AND LIFE SUPPORT TECHNICAL
3/10/2017 8 SCHOOL
SCHOOL LEARNING ACTION CELL: MS OFFICE FOR TEACHERS MARCELO H. DEL PIL
TECHNICAL
INCREASING PROFICIENCY IN MS OFFICE 11/18/2016 8 SCHOOL
MARCELO H. DEL PIL
SCHOOL LEARNING ACTION CELL: PERSONAL EFFECTIVENESS TECHNICAL
10/13/2016 8 SCHOOL
SCHOOL LEARNING ACTION CELL: DELINEATING THE MARCELO H. DEL PIL
TECHNICAL
PERFORMANCE RATING IN RPMS 10/6/2016 8 SCHOOL
SCHOOL LEARNING ACTION CELL: DELINEATING THE REVIEW OF MARCELO H. DEL PIL
TECHNICAL
THE TEACHERS CODE OF ETHICS 9/14/2016 8 SCHOOL
SCHOOL LEARNING ACTION CELL: TEACHERS AS GUIDANCE MARCELO H. DEL PIL
SUPERVISORY
COUNSELLOR
TRAINING ON EARLY CHILDHOOD EDUCATION CUM LOCALIZATION, 8/5/2016 8 SCHOOL
CONYEXTUALIZATION, INDIGENIZATION OF LEARNING
MATERIALSWITH WRITESHOPAND MANIPULIZATION OF
6/7/2016 6/9/2016 24 TECHNICAL DIVISION OF CITY SC
MANIPULATIVES SCIENCE CLUB ADVIS
2016 NATIONAL SCIENCE CONGRESS TECHNICAL
2/1/2015 2/3/2015 24 PHILIPPINES
DIVISION TRAINING OF UNTRAINED TEACHERS ON THE
7/18,24,25/20 DIVISION OF CITY SC
IMPLEMENTATION OF K-12BASIC EDUCATIONPROGRAM (GRADES
15
7/31/2015 32 TECHNICAL
MALOLOS
1-4R AND GRADE 7-10)
DIVISION OF CITY SC
2015 NATIONAL CHILDREN'S SCIENCE CONGRESS 2/1/2015 2/3/2015 24 TECHNICAL
MALOLOS
DIVISION OF CITY SC
DIVISION SIMULTANEOUS IN SERVICE TRAINING 10/20/2014 10/21/2014 16 TECHNICAL
MALOLOS
DIVISION TRAINING OF TRAINERS FOR THE IN SERVICE DIVISION OF CITY SC
TRAINIG FOR TEACHERS
10/17/2014 10/18/2014 16 TECHNICAL
MALOLOS
DIVISION CAPACITY BUILDING FOR MASTER TEACHERS/ DIVISION OF CITY SC
SECONDARY SCHOOLS DEPARTMENT HEAD
9/19/2014 8 TECHNICAL
MALOLOS
MARCELO H. DEL PIL
WALKTHROUGH OFTHE K-12 BASIC EDUCATION PROGRAM 7/5/2014 7/12/2014 16 TECHNICAL
SCHOOL
SCIENCE CLUB ADVIS
NATIONAL CHILDREN'S SCIENCE CONGRESS 2/1/2014 2/3/2014 24 TECHNICAL
PHILIPPINES
2013 NATIONA; SCIENCE CLUB MONTHH CELEBRATION (NSCM) SCIENCE CLUB ADVIS
AND SEMINAR WORKSHOP FOR SCIENCE EDUCATORS
9/26/2013 9/29/2013 32 TECHNICAL
PHILIPPINES
RESEARCH BASED TEACHING AND LEARNING PPROGRESS; MARCELO H. DEL PIL
IMPROVING SELF EFFICACY AND MOTIVATION
7/19/2013 8 TECHNICAL
SCHOOL
MARCELO H. DEL PIL
SEMINAR ON PERFORMANCE ASSESSMENT 5/29/2013 8 TECHNICAL
SCHOOL
TRAINING OF SCIENCE CLUB ADVISERSON REVITLIZATION MARCELO H. DEL PIL
OF SCIENCE EDUCATIONIN THE K-12 EDUCATION PROGRAM
4/ 9/2013 8 TECHNICAL
SCHOOL
2013 NATIONAL CONFERENCEFOR SCIENCE EDUCATORS/ SCIENCE CLUB ADVIS
CUM WORKSHOP
4/27/2013 4/30/2013 32 TECHNICAL
PHILIPPINES
(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMB
NON-ACADEMIC DISTINCTIONS / RECOGNITION ASSOCIATION/ORGA
31. SPECIAL SKILLS and HOBBIES 32. 33.
(Write in full)

FACULTY AND EMPLO

COMPUTER LITERATE , COOKING NONE ASSOCIATION
 MHPNHS CREDIT COO

BOY SCOUT OF TH

THE PHILIPPINE NAT

(Continue on separate sheet if necessary)

SIGNATURE DATE APRIL 2

CS FORM 212 (Re
N-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S

POSITION / NATURE OF WORK

N/A

ntinue on separate sheet if necessary)

ONS/TRAINING PROGRAMS ATTENDED
/training taken for the last five (5) years for Division Chief/Executive/Managerial positions)

CONDUCTED/ SPONSORED BY
(Write in full)

MARCELO H. DEL PILAR NATIONAL HIGH

SCHOOL
MARCELO H. DEL PILAR NATIONAL HIGH
SCHOOL
MARCELO H. DEL PILAR NATIONAL HIGH
SCHOOL
MARCELO H. DEL PILAR NATIONAL HIGH
SCHOOL
MARCELO H. DEL PILAR NATIONAL HIGH
SCHOOL
MARCELO H. DEL PILAR NATIONAL HIGH
SCHOOL
MARCELO H. DEL PILAR NATIONAL HIGH
SCHOOL

DIVISION OF CITY SCHOOLS OF MALOLOS

SCIENCE CLUB ADVISERS OF THE

PHILIPPINES
DIVISION OF CITY SCHOOLS OF
MALOLOS
DIVISION OF CITY SCHOOLS OF
MALOLOS
DIVISION OF CITY SCHOOLS OF
MALOLOS
DIVISION OF CITY SCHOOLS OF
MALOLOS
DIVISION OF CITY SCHOOLS OF
MALOLOS
MARCELO H. DEL PILAR NATIONAL HIGH
SCHOOL
SCIENCE CLUB ADVISERS OF THE
PHILIPPINES
SCIENCE CLUB ADVISERS OF THE
PHILIPPINES
MARCELO H. DEL PILAR NATIONAL HIGH
SCHOOL
MARCELO H. DEL PILAR NATIONAL HIGH
SCHOOL
MARCELO H. DEL PILAR NATIONAL HIGH
SCHOOL
SCIENCE CLUB ADVISERS OF THE
PHILIPPINES
ntinue on separate sheet if necessary)

MEMBERSHIP IN
ASSOCIATION/ORGANIZATION
(Write in
full)
FACULTY AND EMPLOYEES
ASSOCIATION
 MHPNHS CREDIT COOPERATIVE

BOY SCOUT OF THE PHILIPPINES

THE PHILIPPINE NATIONAL RED CROSS

ntinue on separate sheet if necessary)

APRIL 28, 2017

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
YES ✘ NO
regulation 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 YES ✘ NO
last 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
WILLIAM VILEE 2 STO.CRISTO, CITY
DR. HELEN B. AGGABAO OF MALOLOS
7910438 3.5 cm. X 4.5 cm
(passport size)

ST. AGATHA SUBDIVISION, TIKAY, With full and handwritten

DR. MA. VICTORIA C. VIVO CITY OF MALOLOS 9228100368 name tag and signature over
printed name
DR. CONSORCIA M. GREGORIO BULIHAN, CITY OF MALOLOS 9235976849 Computer generated
or photocopied picture
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and is not acceptable
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: PRC

ID/License/Passport No.: 0439776 Signature (Sign inside the box)

APRIL 28,2017
Date/Place of Issuance: MANILA
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