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CS Form No. 212
PERSONAL DATA SHEET
Revised 2017

WARNING: Any misinterpretation made in the Personal Data Sheet and the Work Experience Sheet shall cause the filing of administrative/criminal case/s against the 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 CSC use only)
I. PERSONAL INFORMATION
2. SURNAME GUILLERMO
FIRST NAME CHRISTIAN NAME EXTENSION (JR., SR)
MIDDLE NAME GUMANGAN
3. DATE OF BIRTH 08/01/1994
(mm/dd/yyyy) 16. CITIZENSHIP Filipino Dual Citizenship
by birth by naturalization
4. PLACE OF BIRTH ANGADANAN, ISABELA If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male Female
Single Married 17. RESIDENTIAL ADDRESS
6 CIVIL STATUS
Widowed Separated House/Block/Lot No. Street
Other/s: LORIA
Subdivision/Village Barangay
7. HEIGHT (m) 5'4" ANGADANAN ISABELA
City/Municipality Province
8. WEIGHT (kg) 64 ZIP CODE 3307
9. BLOOD TYPE O 18. PERMANENT ADDRESS
House/Block/Lot No. Street
10. GSIS ID NO. N/A LORIA
Subdivision/Village Barangay
11. PAG-IBIG ID NO. N/A ANGADANAN ISABELA
City/Municipality Province
12. PHILHEALTH NO. 06-050173129-6 ZIP CODE 3307
13. SSS NO. N/A 19. TELEPHONE NO. N/A
14. TIN NO. 452-693-009 20. MOBILE NO. 09366456301
15. AGENCY EMPLOYEE NO. CGG010894 21. E-MAIL ADDRESS (if any) cguillermo413@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
FIRST NAME N/A NAME EXTENSION (JR., SR) N/A N/A
MIDDLE NAME N/A
OCCUPATION N/A
EMPLOYER/BUSINESS NAME N/A
BUSINESS ADDRESS N/A
TELEPHONE NO. N/A
24. FATHER'S SURNAME GUILLERMO
FIRST NAME GUILLERMO NAME EXTENSION (JR., SR)
MIDDLE NAME ANCHETA
25. MOTHER'S MAIDEN NAME
SURNAME GUMANGAN
FIRST NAME CRISENCIA
MIDDLE NAME TABUYO (Continue on separate sheet if necessary)
III. EDUCATIONAL BACKGROUND

26. NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE HIGHEST LEVEL/ YEAR SCHOLARSHIP/
PERIOD OF ATTENDANCE

LEVEL UNITS EARNED GRADUATE ACADEMIC HONORS

(Write in full) (Write in full)
(if not graduated) D RECEIVED
From To
ELEMENTARY ANGADANAN EAST CENTRAL SCHOOL GRADE SCHOOL 2000 2006 2006 Valedictorian
SECONDARY CADALORIA NATIONAL HIGH SCHOOL HIGH SCHOOL 2006 2010 2010 Salutatorian
VOCATIONAL /
N/A
N/A
TRADE COURSE BSBA-Major in Management
COLLEGE ISABELA STATE UNIVERSITY, ECHAGUE, Accounting 2010 2014 2014
Master of Business
ISABELA
GRADUATE STUDIES ISABELA STATE UNIVERSITY, ECHAGUE, Administration-Thesis 2014 2017 2017
ISABELA
PATRIA SABLE CORPUS COLLEGE,
EDUCATION UNITS SANTIAGO CITY, ISABELA BSE Major in Social Science 1st Semester 1st Semester 2016
SY 2016-2017 SY 2016-2017
(Continue on separate sheet if necessary)
SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 1 of 4