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

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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 PHOTO
Computerized Examination Date of Examination (mm/dd/yyyy)
Title (COMEX) (see Specifications at
CSE-Professional CSE-SubProfessional Place of Examination
the back)
Others
Last Examination Taken : (for Career Service Examination Applicants only)
_
CSE-Professional CSE-SubProfessional
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 Educ
Completion:
If graduated, date of Graduation/Completion (mm/dd/yyyy): Honors received: _ _

Complete Titl

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
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 YE S, please specify: _ _

DO NOT FILL-OUT THE SHADED PORTION. (FOR CSC PROCESSOR ONL Y).
Date:
Identification/Other Documents Presented: Details:
O.R. No.
ACT ION T AKEN: 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 of Processor Date d / Processed
Name Receive
(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:

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

W ARNING: 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 APP LICA NTS OF C SE PE N A ND PAPER TEST (C SE -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 APPL ICA NTS OF C SC COM PUTERIZED EXAM INA TIO N (CSC COM EX)
Failure to come on scheduled examination will mean forfeiture of examination fee and slot. Rescheduling of examination date is NOT allowed.
IMP ORTANT: 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)