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

_                

APPLICATION FOR CIVIL SERVICE EXAMINATION

ID PHOTO
(see Specifications at
the back)

To be filled-out by Applicant For CSC Processor ONLY

CSC Regional Office
                                                          _ Date of
Examination (mm/dd/yyyy)
Place of Examination
                                                                     _ Verified
against:
DIBAR E-Retakers EDQIS

Examination Applied For :

Mode Pen and Paper Test (PPT)
Computerized Examination (COMEX)

Title CSE-Professional
CSE-SubProfessional Others
                                                                     

Last Examination Taken : (for Career Service Examination Applicants only)

CSE-Professional CSE-SubProfessional

Date of Exam (mm/dd/yyyy)

Instructions : 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

NAME (Last Name) (First Name) (Ext. Name, e.g. Jr./Sr., if any) (Middle
(e.g. De La Paz = D

AGE DATE OF BIRTH (mm/dd/yyyy) SEX PLACE OF BIRTH (City / Municipality) (Province)
Male Female
CITIZENSHIP M OTHER’S MAIDEN NAME ( Last Name) (First Name) (Middle Name)

COMPLETE PERMANENT MAILING ADDRESS

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 Graduated Graduated If not graduated, highest Year/Level/Units earned:                                                                                                       _
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 / Date
Eligibility Granted
 Government       Private Non-government Organization Self-Employed Unemp

Agency/Office Address Position/Job Title No. of Years in Present

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 conduc
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 decisio
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:                                                                              ACTION
O.R. No.                            DISAPPROVED
Amount:                            Reason:                                                                                                                                                    
                                        _ Signature over Printed Name of Processor / Date
Name of Collecting Officer

APPLICATION NO.  
Date:                                 

O.R. No.                           

Amount:                            Examination Applied For: PPT COMEX Professional SubProfessional Others _            
                                        _
Name of Collecting Officer DATE:                                                                    TIME:                          PLACE:                                                       _
                                                                                                        _                                                                  
Signature over Printed Name of Processor Date Received / Processed

(see Specifications at
the back)

Applicant’s Name:                                                                                                                                                                                                                   

First Name MI Last Name Ext. Name (i.e. Jr./Sr., if any)
Sex: Male Female
Date of Birth (mm/dd/yyyy): Signature:                                                 
 APPLICATION NO. _                _        _

XAMINATION

r ONLY

NOT QUALIFIED.
pplications must be filed PERSONALLY by applicant.

(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)

(Province)

(Middle Name)

ZIP CODE

Person with Disability, please specify _                              

E-MAIL ADDRESS (Required)

aster’s Doctorate
ed, date of Graduation/Completion (mm/dd/yyyy):

                                                             _
lusive years:                                         

Date of Examination / Date Place of Examination

Eligibility Granted
 Self-Employed Unemployed

No. of Years in Present Status of Appointment/

Position/Job Employment

or of infamous, disgraceful or immoral conduct, drunkenness or

NO IF YES, attach copy/ies of decision/s.
YES, please specify:

                                                                     ACTION TAKEN: APPROVED

   

APPLICATION NO.                                               

onal Others _            

                                         _
                    
eceived / Processed

ID PHOTO

             
  
E. DECLARATION
I declare under oath that I personally accomplished this application form, and I certify that the information given are true, correct, and compl
the provisions of pertinent laws, rules, and regulations of the Republic of the Philippines. Further, I declare that I meet and am compliant w
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
further agree that any misrepresentation made in this document shall cause the invalidation of the result of this examination and/or the filin
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 presenc
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;

2. Must be of good moral character;
3. Must have not been convicted by final judgment of an offense or crime involving moral
turpitude, or disgraceful or immoral conduct, dishonesty, examination irregularity,
drunkenness or addiction to drugs;
4. Must have not been dishonorably discharged from military service or dismissed for
cause from any civilian positions in the government; and
5. For Career Service Examination applicants:
a. must be at least 18 years of age on the date of filing of application.
b. must have not taken the same level of Career Service Examination, regardless of mode,
within the last three (3) months before the date of examination.
NOTE: a) Approval of applications may be recalled any time upon discovery of
applicant’s disqualification, for which the examination fees paid shall be forfeited.
b) Applicants holding dual citizenship under R.A. 9225 may apply for and take
the examination upon presentation of original and photocopy of Certification of
Retention/Re- acquisition of Philippine Citizenship from the Bureau of
Immigration, and meeting of all the other admission and application requirements
for the examination.
c) Applicants with pending administrative and/or criminal cases may take the
examination and shall be conferred the eligibility if they successfully pass the
same. However, this is without prejudice to the outcome of their pending cases. If
they are found guilty, their eligibility shall be forfeited based on the penalties
stated in the decision and under existing Civil Service Law and Rules.
d) Passers of the regular Bar examination given by the Supreme Court of
the Philippines and of Board examinations given by the PRC are automatically
granted a civil service eligibility. They are automatically considered as civil service
eligibles pursuant to CSC Resolution No. 90-1212. Thus, they may opt not
to apply and take the corresponding examination anymore. Also, individuals who
were granted the Honor Graduate Eligibility (HGE) pursuant to P.D. 907 may opt not
to apply and take the corresponding examination anymore.
For specific admission requirements 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 b
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 Onli
(ONSA) found in the CSC W ebsite (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 th
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 ass
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. Reschedulin
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, ip
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 entra
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)
 rm, and I certify that the information given are true, correct, and complete statements pursuant to
c of the Philippines. Further, I declare that I meet and am compliant with all the admission

he examination is based on the information I provided.

ntrary to what is declared, my application shall be disapproved, and my payment forfeited. I
cause the invalidation of the result of this examination and/or the filing of administrative/criminal

t should be left blank. These shall only be accomplished in the presence of the Administering

mark

                                                          , 20             .
cer Office / Position

1. Fully accomplished Application Form (CS Form No. 100 Revised September
2016);
2. Four (4) pieces of identical I.D. pictures with specifications, as follows:
 taken within the last three (3) months prior to filing of application
 Philippine passport picture size (4.5 cm x 3.5 cm or 1.78” x 1.38”)
 colored, with white background and printed on good quality photo paper
 in standard close-up shot (from shoulder level up with the head and face occupying at
least 80% of the picture and with the name tag positioned at approximately 1 inch or 2.54
cm. below the chin)
 in bare face (with no eyeglasses, colored contact lens, or any accessories that may
cover the facial features (facial features not computer enhanced)
 showing left and right ears
 taken in full-face view directly facing the camera, with neutral facial expression and both
eyes open
 with handwritten (not computer-generated) name tag legibly showing signature over
printed full name in the format: First Name, Middle Initial, Last Name, and Extension
Name, if any
3. Original and photocopy of any of the following I.D. cards, which must be valid (not
expired upon filing of application), and contains the name, clear picture, date of birth and
signature of applicant, and the name and signature of the issuing agency’s current
head/authorized representative: Driver’s License, Passport, PRC ID, SSS ID, GSIS ID/ GSIS
UMID ID, Philhealth ID (must at least contain the applicant’s name, clear picture, signature
and Philhealth number), current Company/Office ID, current School ID (validated for the
current school year/semester/trimester), Postal ID, BIR ID (ATM type/TIN card type with
picture), Barangay ID, Voter’s ID, Police Clearance/Police Clearance Certificate, or
NBI Clearance (Note: All other ID cards NOT included in the list shall NOT be
accepted).
4. For applicants without date of birth in their I.D. card/s, original and photocopy of
Birth Certificate issued by the Philippine Statistics Authority (formerly National Statistics
Office) or the Local Civil Registry printed on Security Paper (SecPa).
5. For applicants holding dual citizenship under R.A. 9225, original and photocopy of
Certification of Retention/Re-acquisition of Philippine Citizenship issued by the Bureau of
Immigration.
6. Examination fee of PhP500 for the CSE-PPT, or PhP680 for the CSC COMEX. For
fees and additional application requirements of other examinations, please see related
Examination Announcement.

detect cheats. Any form of cheating in any civil service examination shall be considered a violation of
all be administratively and criminally liable.
 Notice of School Assignment (NOSA) via SMS or e-mail. They can also use as applicable the Online Notice of School Assignment
SA, or access related Exam Advisory posted in the CSC website. If applicants still do not know their school assignment or cannot get a
e Regional Office or Field Office where they filed their application to inquire about their school assignment. Applicants are also advised to
come on scheduled examination will mean forfeiture of examination fee and slot. Rescheduling of examination date is NOT

EX)
duling of examination date is NOT allowed.
s, and the like), digital watches/watch calculators, calculators, cellular phones, books, ipads/tablets, and all other electronic
y, must also be surrendered to the security guard/designated firearm custodian at the entrance gate of the testing center.
IN SLEEVELESS SHIRT/BLOUSE, OR IN SHORT PANTS, OR IN SLIPPERS).
MINATION DAY.

3. Black ballpen/s