CS Form No.

212
Revised 2017

PERSONAL DATA SHEET

WARNING: Any misinterpretation made in the Personal Data Sheet and the Work Experience Sheet shall cause the filing of administrative/criminal case/s aga
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

I. PERSONAL INFORMATION
2. SURNAME CALANAO
NAME EXTENSION (JR., SR
FIRST NAME GLORIA

MIDDLE NAME NAVALES

3. DATE OF BIRTH
(mm/dd/yyyy)
4/5/1962 16. CITIZENSHIP ✘ Filipino Dual Citizenship
✘ by birth by
4. PLACE OF BIRTH KIDAPAWAN, NORTH COTABATO If holder of dual citizenship, Pls. indicate cou
please indicate the details.
5. SEX Male ✘ Female

6 CIVIL STATUS Single ✘ Married 17. RESIDENTIAL ADDRESS 4th Block

Widowed Separated House/Block/Lot No. S

Other/s:
Angie Subd., Pob
Subdivision/Village Ba
7. HEIGHT (m) 1.54 m Kidapawan City Cot
City/Municipality Pr
8. WEIGHT (kg) 64 kg ZIP CODE 9400

9. BLOOD TYPE B
18. PERMANENT ADDRESS 4th Block
House/Block/Lot No. S

10. GSIS ID NO. B62H5GNC016 Angie Subd., Pob

Subdivision/Village Ba

11. PAG-IBIG ID NO. NONE Kidapawan City Cot

City/Municipality Pr

12. PHILHEALTH NO. 19-00640380-1 ZIP CODE 9400

13. SSS NO. NONE 19. TELEPHONE NO.

14. TIN NO. 149-077-717 20. MOBILE NO. 09287712958

15. AGENCY EMPLOYEE NO.
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME
FIRST NAME
0814004 21. E-MAIL ADDRESS (if any) gloriacalanao62@gmail.com
CALANAO 23. NAME of CHILDREN (Write full name and list all)
NAME EXTENSION (JR., SR)
ARNULFO ARIANE MAE N. CALANAO

MIDDLE NAME BANDIOLA JEREL JOHN N. CALANAO

OCCUPATION TEACHING

EMPLOYER/BUSINESS NAME DEPED

BUSINESS ADDRESS PACO CENTRAL ELEMENTARY SCHOOL

TELEPHONE NO.

24. FATHER'S SURNAME NAVALES

NAME EXTENSION (JR., SR)
FIRST NAME PASCUAL (DECEASED)

MIDDLE NAME ALVARICO

25. MOTHER'S MAIDEN NAME

SURNAME TANDINGAN

FIRST NAME VICTORIA (DECEASED)

MIDDLE NAME ABALLE (Continue on separate sheet if necessary

III. EDUCATIONAL BACKGROUND

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

ELEMENTARY PANGAO-AN ELEMENTARY SCHOOL ELEMENTARY GRADUATE 1969 1975 GRADUATED

SECONDARY
VOCATIONAL / MAGPET MUNICIPAL HIGH SCHOOL HIGH SCHOOL GRADUATE 1975 1979 GRADUATED

TRADE
COURSE USM – UNIVERSITY OF SOUTHERN BSEED – Bachelor of Science in
COLLEGE 1979 1983 GRADUATED
MINDANAO Elementary Education
CMC – CENTRAL MINDANAO
GRADUATE STUDIES MA – Master of Arts 1985 1988 39 UNITS
COLLEGES
(Continue on separate sheet if necessary)

SIGNATURE DATE 10/09/2019 CS FORM 212 (Re

L DATA SHEET
rience Sheet shall cause the filing of administrative/criminal case/s against the person

EFORE ACCOMPLISHING THE PDS FORM.

(Do not fill up. For CSC use only)

NAME EXTENSION (JR., SR)

Dual Citizenship

by naturalization

Pls. indicate country:

Street
Poblacion
Barangay
Cotabato
Province
9400

Street
Poblacion
Barangay
Cotabato
Province

9400

09287712958

gloriacalanao62@gmail.com

DATE OF BIRTH (mm/dd/yyyy)

8/19/1987

1/14/1992

(Continue on separate sheet if necessary)

SCHOLARSHIP/
YEAR
ACADEMIC
GRADUATED
HONORS
RECEIVED
 ACADEMIC
GRADUATED
HONORS
RECEIVED

1975 NONE

1979 NONE

1983 NONE

NONE

parate sheet if necessary)

CS FORM 212 (Revised 2017), Page 1 of 4

IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable)
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT

RA 1080 PBET 7141% 10/26/1986 COTABATO CITY

(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
(Write in full/Do not (Write in SALARY
applicable)& STEP
(Format "00-0")/
abbreviate) full/Do not abbreviate) INCREMENT
From To

1/1/2019 PRESENT Master Teacher I District I – Kidapawan City 42,688.00 18-3

6/7/2018 1/31/2018 Master Teacher I District I – Kidapawan City 39,952.00 18-3

1/1/2018 6/6/2018 Master Teacher I District I – Kidapawan City 39,477.00 18-3

1/1/2017 1/31/2017 Master Teacher I District I – Kidapawan City 36,960.00 18-3

1/1/2016 12/31/2016 Master Teacher I District I – Kidapawan City 34,603.00 18-3

6/7/2015 12/31/2015 Master Teacher I District I – Kidapawan City 32,397.00 18-3

6/7/2012 6/6/2015 Master Teacher I District I – Kidapawan City 32,044.00 18-3

6/1/2012 6/6/2012 Master Teacher I District I – Kidapawan City 31,696.00 18-2

7/1/2011 5/30/2012 Master Teacher I District I – Kidapawan City 28,684.00 18-2

6/24/2010 6/30/2011 Master Teacher I District I – Kidapawan City 25,671.00 18-2

7/1/2009 6/23/2010 Master Teacher I District I – Kidapawan City 22,659.00 18-2

7/1/2008 6/30/2009 Master Teacher I District I – Kidapawan City 17,454.00 18-1

7/1/2008 6/6/2009 Master Teacher I District I – Kidapawan City 17,009.00 18-1

7/1/2007 6/30/2008 Master Teacher I District I – Kidapawan City 15,508.00 18-1

7/1/2007 6/8/2008 Master Teacher I District I – Kidapawan City 15,508.00 16-1

6/7/2006 6/30/2007 Master Teacher I District I – Kidapawan City 14,098.00 16-1

7/1/2001 6/6/2006 Teacher III District I – Kidapawan City 11,167.00 13-1

6/30/2000 6/30/2001 Teacher III District I – Kidapawan City 10,635.00 13-1

1/1/2000 6/29/2000 Teacher II District I – Kidapawan City 10,033.00 12-4

1/1/1999 12/31/1999 Teacher II District I – Kidapawan City 9,349.00 12-4

11/1/1997 12/31/1998 Teacher II District I – Kidapawan City 9,121.00 12-3

1/1/1997 10/31/1997 Teacher II District I – Kidapawan City 7,682.00 12-1

1/1/1996 12/31/1996 Teacher II District I – Kidapawan City 6,243.00 12-1

1/1/1995 12/31/1995 Teacher II District I – Kidapawan City 5,016.00 12-1

1/1/1994 12/31/1994 Teacher I District I – Kidapawan City 3,902.00 10-1

6/1/1991 12/31/1993 Teacher I District I – Kidapawan City 3,102.00 10-1

1/1/1989 6/16/1991 Teacher I Magpet North District 3,102.00 10-1

1/1/1988 6/30/1989 Teacher I Magpet North District 1,764.00 10-1

5/7/1987 12/31/1987 Teacher I Magpet North District 1,604.00 10-1

3/1/1987 5/6/1987 Teacher I Magpet North District 1,604.00 10-1

7/1/1986 2/28/1987 Teacher I Magpet North District 1,337.00 10-1

1/1/1986 6/30/1986 Teacher I Magpet North District 1,096.00 10-1

1/1/1985 12/31/1985 Teacher I Magpet North District 1,053.00 10-1

1/1/1984 12/31/1984 Teacher I Magpet North District 957.00 10-1

7/25/1983 12/31/1983 Teacher I Magpet North Cotabato 957.00 10-1

(Continue on separate sheet if necessary)

SIGNATURE DATE 10/09/2019 CS FORM 212 (Revised

 LICENSE (if applicable)

NUMBER Date of
Validity

0515684 5/9/1998

e on separate sheet if necessary)

of duties should be indicated in the attached Work Experience sheet. GOV'T

SERVICE

STATUS OF
APPOINTMENT

(Y/
N)
Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Permanent YES

Provisional YES

Provisional YES

Provisional YES

Provisional YES
 Provisional YES

Provisional YES

Provisional YES

Provisional YES

Provisional YES
e on separate 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
(Write in full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / N
From To

GIRL SCOUT OF THE PHILIPPINES 6/17/1905 PRESENT TROOP

KCDOTREMCO 6/ /2016 PRESENT ME

(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 PROGRAMS ( Managerial/ CONDUCTED/ S
NUMBER OF HOURS
(Write in full) Supervisory/
(mm/dd/yyyy)
Technical/etc)
From To
DIVISION TRAINING WORKSHOP FOR MTB-MLE ON SINUGBUHANONG BISAYA P
8/3/2016 8/4/2016 16
ORTHOGRAPHY AND CONTEXTUALIZATION OF CURRICULUM MT
KIDAP
GENDER AND DEVELOPMENT 5/6/2015 5/7/2015 8

KIDAP
GENDER AND DEVELOPMENT 10/21/2014 10/21/2014 8

DIVISION ORIENTATION TRAINING WORKSHOP IN IMPLEMENTATION OF MTB-MLE 7/4/2011 7/25/2011 16 KIDA

DIVISION MASS TRAINING OF GRADE I TEACHERS ON ENGLISH LANGUAGE &

6/7/2010 6/9/2010 24
READING ENHANCEMENT PROGRAM

TRAINING PROGRAM ON THE TEACHING BEGINNERS READING 4/26/2009 5/2/2009 56

BRIGHT MINDS READ – TRAINING FOR TEACHERS ADMINISTRATORS & SUP.

5/24/2008 8 DONALD M
USING FOUR-PRONGED APPLICATION
DIVISION TRAINING FOR THE IMPLEMENTATION OF 2008 SUMMER READING
4/17/2008 4/18/2008 16 DIVISION
PROGRAM FOR PUPILS

REGIONAL EDUCATORS CONGRESS FOR LIFE 8/23/2007 8 DEPED RE

DISTRICT SEMINAR WORKSHOP FOLD DANCING KIDAPAWAN NATIONAL HIGH DISTRI

11/17/2006 11/18/2006 16
SCHOOL
DIVISIO
DISTRICT RE-ECHO SEMINAR REVISED PHYSICAL FITNESS TEST 7/14/2004 7/16/2004 24
S
REGIONAL TRAINING FOR GRADE I TEACHERS ON THE ENRICHMENT OF THE 8
4/28/2003 4/30/2003 24 REGION
WEEKS CURRICULUM

REGIONAL COUNCIL-WIDE GIRL SCOUT TRAINING FOR TRAINERS 11/10/2003 11/15/2003 72 REGIONA

REGIONAL SEMINAR – WORKSHOP FOR GRADE I & II TEACHERS ON SCIENCE

7/18/2003 7/21/2006 24 REGIO
AND ENGLISH INTEGRATION

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

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

FELIPE SUE
DANCING SCOUTING MOVEMENT SCHOOL
KIDAPAW
COOKING GIRL SCOUT OF THE PHILIPPINES SCHOOL T

READING BOOKS SILVER MEDAL OF MERIT AWARD KIDAPAWAN

OF TEACHER
GARDENING GOLD MEDAL OF MERIT AWARD MULTI-

JADE MEDAL OF MERIT AWARD TROOP

(Continue on separate sheet if necessary)

SIGNATURE DATE 10/09/2019

EOPLE / VOLUNTARY ORGANIZATION/S

POSITION / NATURE OF WORK

TROOP LEADERS

MEMBER

ate sheet if necessary)

GRAMS ATTENDED
(5) years for Division Chief/Executive/Managerial positions)

CONDUCTED/ SPONSORED BY
(Write in full)

PRINCIPALS/DIVISION
MTB-MLE SUPERVISORS
KIDAPAWAN CITY PILOT ELEM.
SCHOOL
KIDAPAWAN CITY PILOT ELEM.
SCHOOL

KIDAPAWAN CITY DIVISION

DIVISION STAFF

NATIONAL LEVEL

DONALD MCDONALD HOUSE CHARITIES

DIVISION SUPERVISORS AND STAFF

DEPED REGIONAL DIRECTOR & STAFF

DISTRICT PHYSICAL EDUCATION

COORDINATOR
DIVISION PHYSICAL EDUCATION
SUPERVISOR & STAFF

REGIONAL DIRECTOR AND STAFF

REGIONAL GSP DIRECTOR AND STAFF

REGIONAL DIRECTOR & STAFF

ate sheet if necessary)

 MEMBERSHIP IN ASSOCIATION/ORGANIZATION

(Write in full)

FELIPE SUERTE MEMORIAL ELEMENTARY

SCHOOL TEACHERS ASSOCIATION
KIDAPAWAN CITY DISTRICT I PUBLIC
SCHOOL TEACHERS AND EMPLOYEES
ASSOCIATION
KIDAPAWAN COTABATO DIVISION OFFICE
OF TEACHERS RETIREES AND EMPLOYEES
MULTI-PURPOSE COOPERATIVE

TROOP LEADERS ASSOCIATION

ate sheet if necessary)

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 ✘ NO
b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘ NO
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 NO
YES ✘
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 withi
the last 6 months
ROGELIO C. BOLASA Saguing, Makilala, Cotabato 3.5 cm. X 4.5 cm
(passport size)

JOSEFINA H. ESCANER Apo Sandawa Phase II, Kidapawan City With full and handwrit
name tag and signature
printed name

Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied pictur
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.: 0515684 Signature (Sign inside the box)
10/09/2019
Date/Place of Issuance: 12/9/1998 / DAVAO CITY Date Accomplished Right Thumbmark

SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated a
Person Administering Oath

CS FORM 212 (Revised 201

 If YES, give details:
________________________________

If YES, give details:

________________________________
________________________________

If YES, give details:

________________________________
________________________________

If YES, give details:

________________________________
________________________________

If YES, give details:

________________________________
________________________________
✘ NO

✘ NO

✘ NO
If YES, give details (country):

✘ NO

✘ NO

✘ NO

ID picture taken within

the last 6 months
3.5 cm. X 4.5 cm
(passport size)

With full and handwritten

name tag and signature over
printed name

Computer generated
or photocopied picture
is not acceptable

PHOTO

Right Thumbmark

, affiant exhibiting his/her validly issued government ID as indicated above.

CS FORM 212 (Revised 2017), Page 4 of 4