032117 CS Form No. 212 Revised Personal Data Sheet_new

PERSONAL DATA SHEET

PERSONAL DATA SHEET

READ THE ATTACHED GUIDE TO FILLING OUT THE

READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATPERSONAL DATA SHEET (PDS) A SHEET (PDS) BEFORE ACCOMPLISHING THE PDS BEFORE ACCOMPLISHING THE PDS FORM.FORM.

11. . CCS S IID D NNoo. . ((DDo o nnoot t ffiilll l uupp. . FFoor r CCSSC C uusse e oonnllyy))

I. PERSONAL

I. PERSONAL

INFORMA

INFORMA

TION 

TION 

2.

2. SURNASURNAMEME FIRST NAME

FIRST NAME NAME EXTENSIN (!R." SR)NAME EXTENSIN (!R." SR)

MIDD#E NAME MIDD#E NAME $. $. 1%. CITI&ENS'I 1%. CITI&ENS'I

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II.

II.

FAMIL

FAMIL

Y

Y

BACKGROU

BACKGROU

ND

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FIRST NAME   MID

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2. FAFAT'ET'ER>S SR>S SURNURNAMEAME FIRST NAME FIRST NAME MIDD#E NAME MIDD#E NAME 2.

2. MT'EMT'ER>S MAR>S MAIDEN NIDEN NAMEAME SURNAME

SURNAME FIRST NAME FIRST NAME MIDD#E NAME

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III. EDUCATIONAL BACKGROUND

III. EDUCATIONAL BACKGROUND

2%. 2%.

#EE#

#EE# ERID F ATTENDANCEERID F ATTENDANCE

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E#EMENTAR;

WARNING: Any misreresen!"!i#n m"$e in !%e Pers#n"& D"!" S%ee! "n$ !%e W#r' Eeriene S%ee! s%"&& "*se !%e +i&in, #+ "$minis!r"!i-erimin"& "ses ","ins! !%e ers#n WARNING: Any misreresen!"!i#n m"$e in !%e Pers#n"& D"!" S%ee! "n$ !%e W#r' Eeriene S%ee! s%"&& "*se !%e +i&in, #+ "$minis!r"!i-erimin"& "ses ","ins! !%e ers#n #nerne$.

#nerne$. rint le9i@ly.

rint le9i@ly. Ti8 -ppropri-te @oes Ti8 -ppropri-te @oes ( ( ) -n, use sep-r-te s+eet ) -n, use sep-r-te s+eet if neess-ryif neess-ry. In,i-te N?A . In,i-te N?A if not -ppli[email protected] not -ppli-@le. DO NOT ABBREVIATE.DO NOT ABBREVIATE.

DATE F *IRT' DATE F *IRT' (55?,,?yyyy) (55?,,?yyyy) NAME EXTENSIN (!R." SR) NAME EXTENSIN (!R." SR) NAME EXTENSIN (!R." SR) NAME EXTENSIN (!R." SR) NAME F SC'# NAME F SC'# (7rite in (7rite in full) full) *ASIC

*ASIC EDUCATIN?DE4REE?CUREDUCATIN?DE4REE?CURSESE (7rite in full) (7rite in full) HIGHEST LEVEL/ HIGHEST LEVEL/ UNITS UNITS EARNED EARNED (if not graduated) (if not graduated)

YEAR YEAR GRADUATED GRADUATED SC'#ARS'I? SC'#ARS'I? ACADEMIC ACADEMIC 'NRS 'NRS RECEIED RECEIED CS Form No. 212 CS Form No. 212 Revised 2017 Revised 2017

I&. CI&IL SER&ICE ELIGIBILITY 

23.

#ACE F EXAMINATIN ? CNFERMENT

#ICENSE (if -ppli-@le) NUM*ER

CAREER SERVICE PROFESSIONAL EXAMINATION 6$.1B

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&. 'ORK EPERIENCE

(In#)u*e pi+ate e,p)o$,ent. Stat "o, $ou e#ent -o% Des#iption o" *uties s!ou)* /e in*i#ate* in t!e atta#!e* 'o E0peien#e s!eet.

26.

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PRESENT

COURT LEGAL RESEARCHER II

REGIONAL TRIAL COURT BR. 193

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COURT SHERIFF IV

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CAREER SERICE? RA 1<6< (*ARD? *AR) UNDER SECIA# #A7S? CES? CSEE

*ARAN4A; E#I4I*I#IT; ? DRIER>S #ICENSE

RATIN4 (If Appli-@le) DATE F EXAMINATIN ? CNFERMENT D-te of -li,ity

CIVIL SERVICE COMMISSION-NATIONAL

CAPITAL REGION (CSC-NCR)

INC#USIE DATES

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DEARTMENT ? A4ENC; ? FFICE ? CMAN; (7rite in full?Do not -@@rei-te)

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SIGNATURE

DATE

 

&I. &OLUNTARY 'ORK OR IN&OL&EMENT IN CI&IC 1 NON2GO&ERNMENT 1 PEOPLE 1 &OLUNTARY ORGANI3ATION1S

2:.

NUM*ER F 'URS SITIN ? NATURE F 7R

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&II. LEARNING AND DE&ELOPMENT (L4D% INTER&ENTIONS1TRAINING PROGRAMS ATTENDED

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NUM*ER F 'URS

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&III. OT7ER INFORMATION 

$1. SECIA#SI##S-n,'**IES $2. $$.

NAME  ADDRESS F R4ANI&ATIN

(7rite in full)

INC#USIE DATES

(55?,,?yyyy)

TIT#E F #EARNIN4 AND DEE#MENT INTERENTINS?TRAININ4 R4RAMS (7rite in full) INC#USIE DATES F ATTENDANCE (55?,,?yyyy) Type of #D  ( M-n-9eri-l? Superisory? Te+ni-l?et) CNDUCTED? SNSRED *; (7rite in full)

NN=ACADEMIC DISTINCTINS ? REC4NITIN

(7rite in full)

MEM*ERS'I IN ASSCIATIN?R4ANI&ATIN (7rite in full)

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SIGNATURE

DATE