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 ABIOL

FIRST NAME ROBERT KANE NAME EXTENSION (JR., SR) N/A

MIDDLE NAME OMISOL

3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) 5/5/1993 ✘ Filipino Dual Citizenship
by
by naturalization
birth
4. PLACE OF BIRTH ILIGAN CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX ✘ Male Female

6 CIVIL STATUS ✘ Single Married 17. RESIDENTIAL ADDRESS N/A N/A

Widowed House/Block/Lot No. Street
Separate
ZONE TAURUS SUAREZ
Other/s: d
Subdivision/Village Barangay
7. HEIGHT (m) 1.7018 ILIGAN CITY LANAO DEL NORTE
City/Municipality Province
8. WEIGHT (kg) 57 ZIP CODE 9000

9. BLOOD TYPE O
18. PERMANENT ADDRESS N/A N/A
House/Block/Lot No. Street
10. GSIS ID NO. 2006358558 ZONE TAURUS SUAREZ
Subdivision/Village Barangay

11. PAG-IBIG ID NO. 1211-5630-3014 ILIGAN CITY LANAO DEL NORTE

City/Municipality Province

12. PHILHEALTH NO. 15-050412595-7 ZIP CODE 9000

13. SSS NO. 0824532754 19. TELEPHONE NO. N/A

14. TIN NO. 3237-0914-50000 20. MOBILE NO. 09816378380

15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) [email protected]

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)
NAME EXTENSION (JR., SR) N/A
FIRST NAME N/A 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 ABIOL

NAME EXTENSION (JR., SR)
FIRST NAME KENNEDY N/A
MIDDLE NAME NAVARRO

25. MOTHER'S MAIDEN NAME

SURNAME ABIOL

FIRST NAME ELVIE

MIDDLE NAME OMISOL (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

NAME OF SCHOOL HIGHEST LEVEL/ SCHOLARSHIP/
26. PERIOD OF ATTENDANCE YEAR
BASIC EDUCATION/DEGREE/COURSE UNITS ACADEMIC
LEVEL (Write in EARNED
GRADUATED
(Write in full) HONORS
full) (if not graduated) RECEIVED
From To

ELEMENTARY SUAREZ CENTRAL SCHOOL PRIMARY EDUCATION 2000 2005 N/A 2005 N/A

SECONDARY /
VOCATIONAL ST. CATHERINE ACADEMY HIGH SCHOOL 2005 2009 N/A 2009 N/A

CHRISTIAN HORIZON SCHOOL, INC. HOUSEKEEPING NC II 2017 2017 N/A 2017 N/A
TRADE BACHELOR OF ELEMENTARY
COURSE
COLLEGE ILIGAN CAPITOL COLLEGE EDUCATION MAJOR IN GENERAL 2009 2014 N/A 2014 N/A
EDUCATION

GRADUATE STUDIES N/A N/A N/A N/A N/A N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE JULY 29, 2024

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
LICENSURE EXAMINATION FOR PROFESSIONAL
78.6 03/29/2015 CAGAYAN DE ORO, CITY 1377592 5/5/2027
TEACHERS

(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)
DEPARTMENT OF EDUCATION-DIVISION
1/8/2023 03/29/2024 TEACHER 1 P27,000.00 11-1 SUBSTITUTE YES
OF ILIGAN CITY
1/8/2022 06/30/2023 TEACHER ST. CATHERINE ACADEMY P11,600.00 N/A PROBATIONARY NO

1/8/2021 1/6/2022 TEACHER ST. CATHERINE ACADEMY P9,950.00 N/A PROBATIONARY NO

1/8/2020 1/6/2021 TEACHER CHRISTIAN HORIZON SCHOOL, INC. P10,669.00 N/A REGULAR NO

1/6/2019 03/31/2020 TEACHER CHRISTIAN HORIZON SCHOOL, INC. P9,800.14 N/A REGULAR NO

1/6/2018 03/31/2019 TEACHER CHRISTIAN HORIZON SCHOOL, INC. P9,012.96 N/A PROBATIONARY NO

1/6/2017 03/31/2018 TEACHER CHRISTIAN HORIZON SCHOOL, INC. P8,050.00 N/A PROBATIONARY NO

1/6/2016 03/31/2017 TEACHER ST. MATTHEW MONTESORRI SCHOOL P4,000.00 N/A PROBATIONARY NO

11/1/2015 05/31/2016 SERVICE CREW JOLLIBEE INCORPORATION P7,000.00 N/A PROBATIONARY NO

4/1/2013 10/30/2015 STAFF/ PART-TIME LECTURER ST. LOUIS REVIEW CENTER-ILIGAN P6,000.00 N/A PROBATIONARY NO

(Continue on separate sheet if necessary)

SIGNATURE DATE JULY 29, 2024

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

DIVISION MEET: TRACK AND FIELD 11/3/2023 11/3/2023 8 COACH

PRISAA 2023: TRACK AND FIELD 02/23/2023 02/23/2023 8 COACH

CHRISTIAN HORIZON SCHOOL WIZARDS CLUB 5/7/2019 03/15/2020 32 TRAINER

15th LPCC CONSUMER QUIZ 2019 10/10/2019 10/10/2019 24 COACH

CHRISTIAN HORIZON SCHOOL, INC. - "SOARING HIGH TOWARDS EXCELLENCE

02/21/2019 02/25/2019 16 SOUND SYSTEM OPERATOR
BY EMPOWERING THE MILLENIALS THROUGH TECHNOVATION

CHRISTIAN HORIZON SCHOOL - MATH WIZARDS CLUB 6/7/2018 02/22/2019 24 TRAINER

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
INCLUSIVE DATES OF
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ( Managerial/ CONDUCTED/ SPONSORED BY
NUMBER OF HOURS
(Write in full) (mm/dd/yyyy) Supervisory/ (Write in full)
Technical/etc)
From To

2024 3-DAY IN-SERVICE TRAINING FOR TEACHERS (INSET) 01/27/2024 01/29/2024 24 TECHNICAL DEPARTMENT OF EDUCATION

2024 2-DAY GENDER AND DEVELOPMENT (GAD) TRAINING AND SEMINAR 5/12/2023 6/12/2023 16 TECHNICAL DEPARTMENT OF EDUCATION

2020 IN-SERVICE TRAINING FOR JUNIOR HIGH SCHOOL TEACHERS ENSURING

DEPARTMENT OF EDUCATION - PRIVATE
ENDURING STUDENT LEARNING OUTCOMES WITH ONLINE DISTANCE 5/10/2020 7/10/2020 15 TECHNICAL
EDUCATION ASSISTANCE COMMITTEE
LEARNING AND TEACHING OF K-12 STANDARDS IN THE TIME OF COVID-19

(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)

DANCING DIVISION MEET: TRACK AND FIELD - COACH ILIGAN CAPITOL COLLEGE - ALUMNI
COMPUTER LITERATE (MSWord, Excel,
PRISAA 2023: TRACK AND FIELD - COACH
Powerpoint, Publisher)
PHOTO/VIDEO/AUDIO EDITING 15th LPCC CONSUMER QUIZ 2019 - COACH

4th PLACE DANZTRACK COMPETITION TEACHER'S CATEGORY YEAR 2018

2nd PLACE DANZTRACK COMPETITION TEACHER'S CATEGORY YEAR 2017

4th PLACE DANZTRACK COMPETITION TEACHER'S CATEGORY YEAR 2016

(Continue on separate sheet if necessary)

SIGNATURE DATE JULY 29, 2024

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

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

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

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

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

NAME ADDRESS TEL. NO.

ID picture taken within
the last 6 months
SALLY R. QUILANTANG PALAO, ILIGAN CITY 9557693671 4.5 cm. X 3.5 cm
(passport size)

JENITH S. LOPEZ PALAO, ILIGAN CITY 9924465710

Computer generated
or photocopied picture
CHEMABEL J. CASABERDE ILIGAN CITY 9755985722 is not acceptable

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: PRC
ID/License/Passport No.: 1377592 Signature (Sign inside the box)
JULY 29, 2024
Date/Place of Issuance: CAGAYAN DE ORO CITY 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