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 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 RAGUDO
NAME EXTENSION (JR., SR)
FIRST NAME JOY PAUL
MIDDLE NAME AUTENTICO
3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) 1/5/1995 ✘ Filipino Dual Citizenship
by birth by naturalization
4. PLACE OF BIRTH DAVAO CITY, MINDANAO If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX ✘ Male Female

6 CIVIL STATUS ✘ Single Married 17. RESIDENTIAL ADDRESS

Widowed Separated House/Block/Lot No. Street
PUROK 5 HINLAYAGAN
Other/s:
Subdivision/Village Barangay
7. HEIGHT (m) 1.55 m TRINIDAD BOHOL
City/Municipality Province
8. WEIGHT (kg) 80 kg ZIP CODE 6324
18. PERMANENT ADDRESS
9. BLOOD TYPE O+
House/Block/Lot No. Street

10. GSIS ID NO. PUROK 5 HINLAYAGAN

Subdivision/Village Barangay

11. PAG-IBIG ID NO.

TRINIDAD BOHOL
City/Municipality Province
12. PHILHEALTH NO. ZIP CODE 6324
13. SSS NO. 19. TELEPHONE NO. N/A
14. TIN NO. 20. MOBILE NO. 0946 723 5519
15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any) [email protected]
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) N/A
FIRST NAME N/A

MIDDLE NAME N/A N/A

OCCUPATION N/A N/A

EMPLOYER/BUSINESS NAME N/A N/A
BUSINESS ADDRESS N/A N/A
TELEPHONE NO. N/A N/A
24. FATHER'S SURNAME RAGUDO SR. N/A N/A
NAME EXTENSION (JR., SR) N/A
FIRST NAME ARTURO JR
N/A
MIDDLE NAME BOSAYONG N/A N/A
25. MOTHER'S MAIDEN NAME BALONGA N/A N/A
SURNAME RAGUDO N/A N/A
FIRST NAME TABITA N/A N/A
MIDDLE NAME AUTENTICO (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND HIGHEST

LEVEL/
NAME OF SCHOOL SCHOLARSHIP/
26. BASIC EDUCATION/DEGREE/COURSE PERIOD OF ATTENDANCE YEAR ACADEMIC
LEVEL (Write UNITS
GRADUATED HONORS
(Write in full) EARNED
in full) RECEIVED
From To (if not
graduated)
ELEMENTARY IPIL HEIGHT ELEMENTARY SCHOOL GRADUATE 2002 2007 2007
VOCATIONAL /
SECONDARY HINLAYAGAN NATIONAL HIGH SCHOOL GRAUATE 2007 2011 2011
TRINIDAD MUNICIPAL COLLEGE SHEILDED METAL ARC WELDING NCII 2016 2017 2017
COLLEGE TRADE BOHOL ISLAND STATE UNIVERSITY BS COMPUTER SCIENCE 2015 2019 2019
COURSE
CEBU TECHNOLOGICAL UNIVERSITY MASTER IN PUBLIC ADMINISTRATION 2019 2020 30.0

(Continue on separate sheet if necessary)

SIGNATURE DATE September 23, 2021

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 applicable)
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER Date of
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity

(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.
GOV'T
28. INCLUSIVE DATES SALARY/ JOB/ PAY SERVICE
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
(Y/ N)
CONTRACT OF
8/5/2019 5/31/2021 COLLEGE INSTRUCTOR TRINIDAD MUNICIPAL COLLEGE N/A N/A
SERVICE Y

(Continue on separate sheet if necessary)

SIGNATURE DATE September 23, 2021

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) NUMBER OF HOURS POSITION / NATURE OF WORK
(mm/dd/yyyy)
From To

NEW YOUNG PILIPINO DEFENDERS 9/5/2019 1/15/2021 MEMBER

TASK FORCE KASANAG MEMBER

(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 ( Managerial/ CONDUCTED/ SPONSORED BY
NUMBER OF HOURS
PROGRAMS (Write in full) Supervisory/ (Write in full)
(mm/dd/yyyy) Technical/etc)
From To

Professional Enhancement Forum 3/2/2019 3/2/2019 ARNULFO C. OLANDRIA, Ph. D.

4rth ICT SUMMIT 11/9/2019 11/9/2019 CLARK KEVIN VILLAMOR, MIT

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

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

Playing Ball Games

Playing Instruments

Can speak Visayan, Tagalog, English

Can operate Computer

(Continue on separate sheet if necessary)

SIGNATURE DATE September 23, 2021

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 YES ✘ NO
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, YES ✘ NO
a. within the third degree? If YES, give details:
________________________________
b. within the fourth degree (for Local Government Unit - Career Employees)?
________________________________
YES ✘ NO

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? ________________________________
If YES, give details:
________________________________
Date Filed:
________________________________
Status of Case/s:
YES ✘ NO

36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or If YES, give details:
regulation by any court or tribunal? ________________________________
________________________________
YES ✘ NO

37. Have you ever been separated from the service in any of the following modes: resignation, If YES, give details:
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract or ________________________________
phased out (abolition) in the public or private sector? ________________________________
YES ✘ NO
38. a. Have you ever been a candidate in a national or local election held within the last year If YES, give details:
(except Barangay election)? ________________________________
YES ✘ NO
________________________________
b. Have you resigned from the government service during the three (3)-month period before the If YES, give details:
last election to promote/actively campaign for a national or local candidate? ________________________________
YES ✘ NO
________________________________
39. Have you acquired the status of an immigrant or permanent resident of another country?
If YES, give details (country):

40. Pursuant to: (a) Indigenous People's Act (RA 8371); (b) Magna Carta for Disabled Persons (RA YES ✘ NO
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?
If YES, please specify ID No:

41. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)

NAME ADDRESS TEL. NO.

ALBERT DUTERTE JUAREZ PROVINCE OF BOHOL 9752463819

GLENDOL A. BADON

42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and
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:

ID/License/Passport No.:
Signature (Sign inside the box)
September 23, 2021
Date/Place of Issuance:
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