CS FORM No. 100 (Revised September 2016) . This Form is NOT for sale. Reproduction is allowed. APPLICATION NO.

_ _ _

APPLICATION FOR CIVIL SERVICE EXAMINATION

To be filled-out by Applicant For CSC Processor ONLY
Examination Applied For : CSC Regional Office
Mode Pen and Paper Test (PPT) _ ID
Computerized Examination (COMEX) Date of Examination (mm/dd/yyyy)
PHOTO
Title CSE-Professional CSE-SubProfessional
Others
(see
Place of Examination
Specifications at
the back)
Last Examination Taken : (for Career Service Examination Applicants only)
_
CSE-Professional CSE-SubProfessional
Verified against:
Date of Exam (mm/dd/yyyy) DIBAR E-Retakers EDQIS

In stru ctio n s : READ ADMISSION AND APPLICATION REQUIREMENTS AT THE BACK PAGE. DO NOT APPLY IF NOT QUALIFIED.
Fill in all the required information. DO NOT leave an item blank. If item is not applicable, indicate “N/A”. All applications must be filed PERSONALLY
by applicant.

NAME (Last Name) (First Name) (Ext. Name, e.g. Jr./Sr., if any) (Middle Name) (M.I.)
(e.g. De La Paz= D, P, or DLP; Dela Paz =D, P,or DP)
AGE DATE OF BIRTH (mm/dd/yyyy) SEX PLACE OF BIRTH (City / Municipality) (Province)
Male Female
CITIZENSHIP MOTHER’S MAIDEN NAME ( Last Name) (First Name) (Middle Name)

COMPLETE PERMANENT MAILING ADDRESS ZIP CODE

HEIGHT (meters) WEIGHT (kg) CIVIL STATUS OTHER DATA
. . Single Married Others Pregnant Person with Disability, please specify _
MOBILE NUMBER (Required) TELEPHONE NUMBER (include Area Code) E-MAIL ADDRESS (Required)

Level of Education: Elementary High School College Master’s Doctorate

Completion: Not Graduate If not graduated, highest Year/Level/Units earned: _
Graduated d
If graduated, date of Graduation/Completion (mm/dd/yyyy):
Honors received: _ _

Complete Title of Course/Degree (for College, Master’s, Doctorate): _ Major: _

Name and Address of School Attended: Inclusive years:

(from-to)

Title of Examination Passed / Title of Eligibility Granted Rating Obtained Date of Examination / Place of Examination
Date Eligibility Granted

Government Private Non-government Organization Self-Employed

Unemployed
No. of Years in Present Status of Appointment/
Agency/Office Address Position/Job Title Employment
Position/Job

1. Have you ever been dismissed from the military/civil service for cause, or found guilty of crime involving moral turpitude, or of infamous, disgraceful or
immoral conduct, drunkenness or addiction to drugs, or of an offense relative to, or in connection with, the conduct of a civil service examination?
YES NO IF YES, attach copy/ies of decision/s.

2. Pursuant to the Indigenous People’s Act (RA 8371), are you a member of any indigenous group? YES NO
If YES, please specify: _ _

DO NOT FILL-OUT THE SHADED PORTION. (FOR CSC PROCESSOR ONLY).

Date:
Identification/Other Documents Presented: Details:
O.R. No.
ACTION TAKEN: APPROVED DISAPPROVED
Amount:
Reason:
_ Signature over Printed Name of Processor / Date
Name of Collecting Officer

APPLICATION NO.
Date:

O.R. No. Examination Applied For: PPT COMEX Professional SubProfessional Others _
Amount:
DATE: TIME: PLACE: _
_
Name of Collecting Officer _ ID PHOTO
Signature over Printed Name of Processor Date Received / Processed

(see
Specificatio
Applicant’s Name: ns at the
First Name MI Last Name Ext. Name (i.e. Jr./Sr., if any)

back)
Sex: Male Female Date of Birth (mm/dd/yyyy): Signature:
E. DECLARATION

I declare under oath that I personally accomplished this application form, and I certify that the information given are true, correct, and
complete statements pursuant to the provisions of pertinent laws, rules, and regulations of the Republic of the Philippines. Further, I declare
that I meet and am compliant with all the admission requirements for the examination for which this application is filed.
I understand that the acceptance and approval of my application for the examination is based on the information I provided.
I therefore agree that, in case a post-verification yields information contrary to what is declared, my application shall be disapproved,
and my payment forfeited. I further agree that any misrepresentation made in this document shall cause the invalidation of the result of
this examination and/or the filing of administrative/criminal case/s against me.

Note: Spaces for Signature/Printed Name and

Right Thumbmark of applicant should be left
blank. These shall only be accomplished in
the presence of the Administering
Officer/CSC Processor.

Signature over Printed Name of Applicant Right Thumbmark

Subscribed and sworn to before me this day of , 20 .

Signature over Printed Name of Administering Officer Office / Position

1. Must be Filipino citizen; 1. Fully accomplished Application Form (CS Form No. 100
2. Must be of good moral character; Revised
3. Must have not been convicted by final judgment of an offense or September
crime involving moral turpitude, or disgraceful or immoral 2016);
conduct, dishonesty, examination irregularity, drunkenness or 2. Four (4) pieces of identical I.D. pictures with specifications, as follows:
addiction to drugs; taken within the last three (3) months prior to filing of
4. Must have not been dishonorably discharged from military application
service or dismissed for cause from any civilian positions in the Philippine passport picture size (4.5 cm x 3.5 cm or 1.78” x
government; and 1.38”)
5. For Career Service Examination applicants: colored, with white background and printed on good quality
a. must be at least 18 years of age on the date of filing of photo paper
application. in standard close-up shot (from shoulder level up with the head and
b. must have not taken the same level of Career Service face occupying at least 80% of the picture and with the
Examination, regardless of mode, within the last three (3) name tag positioned at approximately 1 inch or 2.54 cm. below
months before the date of examination. the chin)
NOTE: a) Approval of applications may be recalled any time upon in bare face (with no eyeglasses, colored contact lens, or any
discovery of applicant’s disqualification, for which accessories that may cover the facial features (facial features
the examination fees paid shall be forfeited. not computer enhanced)
b) Applicants holding dual citizenship under R.A. 9225 showing left and right ears
may taken in full-face view directly facing the camera, with neutral
apply for and take the examination upon facial expression and both eyes open
presentation of original and photocopy of Certification with handwritten (not computer-generated) name tag legibly
of Retention/Re- acquisition of Philippine Citizenship showing signature over printed full name in the format: First
from the Bureau of Immigration, and meeting of all Name, Middle Initial, Last Name, and Extension Name, if any
the other admission and application requirements for 3. Original and photocopy of any of the following I.D. cards, which must
the examination. be
c) Applicants with pending administrative and/or criminal valid (not expired upon filing of application), and contains the
cases may take the examination and shall be name, clear picture, date of birth and signature of applicant, and the
conferred the eligibility if they successfully pass the name and signature of the issuing agency’s current head/authorized
same. However, this is without prejudice to the outcome representative: Driver’s License, Passport, PRC ID, SSS ID, GSIS
of their pending cases. If they are found guilty, their ID/ GSIS UMID ID, Philhealth ID (must at least contain the
eligibility shall be forfeited based on the penalties applicant’s name, clear picture, signature and Philhealth number),
stated in the decision and under existing Civil Service current Company/Office ID, current School ID (validated for the
Law and Rules. current school year/semester/trimester), Postal ID, BIR ID (ATM
d) Passers of the regular Bar examination given by type/TIN card type with picture), Barangay ID, Voter’s ID, Police
the Supreme Court of the Philippines and of Clearance/Police Clearance Certificate, or NBI Clearance
Board examinations given by the PRC are automatically (Note: All other ID cards NOT included in the list shall NOT be
granted a civil service eligibility. They are automatically accepted).
considered as civil service eligibles pursuant to 4. For applicants without date of birth in their I.D. card/s, original
CSC Resolution No. and photocopy of Birth Certificate issued by the Philippine Statistics
90-1212. Thus, they may opt not to apply and take Authority (formerly National Statistics Office) or the Local Civil
the corresponding examination anymore. Also, Registry printed on Security Paper (SecPa).
individuals who were granted the Honor Graduate 5. For applicants holding dual citizenship under R.A. 9225, original
Eligibility (HGE) pursuant to P.D. 907 may opt not to and photocopy of Certification of Retention/Re-acquisition of
apply and take the corresponding examination anymore. Philippine Citizenship issued by the Bureau of Immigration.
For specific admission requirements of other examinations, please 6. Examination fee of PhP500 for the CSE-PPT, or PhP680 for the
CSC COMEX. For fees and additional application requirements
see related Examination Announcement.
of other examinations, please see related Examination
Announcement.

WARNING: The Civil Service Commission uses a highly reliable system to detect cheats. Any form of cheating in any civil service examination shall be
considered a violation of Republic Act No. 9416 (Anti-Cheating Law), and any person found guilty shall be administratively and criminally liable.

A. FOR APPLICANTS OF CSE PEN AND PAPER TEST (CSE-PPT)

Qualified applicants shall be notified of their school assignment through an Application Receipt or a Notice of School Assignment (NOSA) via SMS or e-mail. They can also use as
applicable the Online Notice of School Assignment (ONSA) found in the CSC Website (www.csc.gov.ph) to verify and get a print-out of their NOSA, or access related Exam
Advisory posted in the CSC website. If applicants still do not know their school assignment or cannot get a copy of their NOSA via internet one (1) week before the examination day,
they should visit or call the Regional Office or Field Office where they filed their application to inquire about their school assignment. Applicants are also advised to conduct ocular
inspection of their school assignment one (1) day before examination day. Failure to come on scheduled examination will mean forfeiture of examination fee and slot.
Rescheduling of examination date is NOT allowed.
B. FOR APPLICANTS OF CSC COMPUTERIZED EXAMINATION (CSC COMEX)
Failure to come on scheduled examination will mean forfeiture of examination fee and slot. Rescheduling of examination date is NOT allowed.
IMPORTANT: All personal belongings including articles in clothing (hats/caps, shades, and the like), digital watches/watch calculators, calculators, cellular phones,
books, ipads/tablets, and all other electronic gadgets and printed materials shall be surrendered to the Room Examiners. Firearms, if any, must also be surrendered to
the security guard/designated firearm custodian at the entrance gate of the testing center. Proper attire should be worn on filing of application form and on examination day
(e.g. NOT IN SLEEVELESS SHIRT/BLOUSE, OR IN SHORT PANTS, OR IN SLIPPERS).
 MAIN GATES OF TESTING VENUES SHALL BE CLOSED AT 7:30 A.M. ON EXAMINATION DAY.

1. This Application Receipt and/or Notice of School Assignment 3. Black ballpen/s

2. Same valid I.D. presented at the time of filing of application (NO I.D., NO EXAM)