TRAINOR’S/ASSESSOR’S PROFILE
ID PICTURE
(2”x 2” size)
Applicant’s Signature
1. To be accomplished by TESDA
1.1. NMIS Manpower Code: - 1.2. NMIS Entry Date:
2. Manpower Profile
2.1. Name:
Last First Middle
2.2.
Mailing
Address:
Number, Street Barangay District
City Province Region Zip Code P.O. Box No.
2.3. Sex 2.4. Civil Status 2.5. Contact Number(s) 2.6. Employment Type 2.7. Employment Status
Male Single Tel: Employed Casual Probationary
Female Married Cellular: Self-employed Contractual Regular
Window/er e-mail : Unemployed Job Order Permanent
Separated Fax: Other than above Temporary
Others: Pls. specify If Student
Trainee/OJT
3. Personal Information
3.1. Birthdate: 3.6. Weight: 3.11. Distinguishing Marks:_____________
3.2. Birth Place: 3.7. Blood Type: ______________________________
3.3. Citizenship: 3.8. SSS No.:
3.4. Religion: 3.9. GSIS No.:
3.5. Height: 3.10. TIN No:
4. Educational Background
4.1. 4.2. 4.3. 4.4. 4.5. 4.6. 4.7 4.8.
Educational Units Honors
School Level School Year Degree Minor Major Earned Received
5. Course Title (for TPIS, CACs) 5.2. Schedule /Duration 5.3. Aptitude Exam
5.1. Schedule
*Training Duration (No. of Hrs.)
Date:
*From:
*To: Time:
For Competency Assessment and Certification Applicants Only, fill-up this part.
6. Competency Assessment to Take (to be filled-up by TESDA Representative)
6.1. Date of Application: / / 6.7. Training Program 6.8. Program Sector 6.9. Client Type
(mm) (dd) (year) TESDA Grad.
6.2. Sector Component: Formal Public Person with Disability
6.3. Trade Area: Non-Formal Industry SCEP
6.4. Occupation: Informal (prior learning) OFW Non-TESDA Grad.
6.5. Classification: Other; OFW
6.6. Competency: Farmers; Fisherfolks
OSY
Others, pls. specify
Part II: The following entries can be skipped if you have previously filled up this form, except for some information that you would want to update.
7. WORKING EXPERIENCE ( For Trainers, mandatory field 7.5)
7.1. 7.2. 7.3. 7.4. 7.5. 7.6.
Occupation Type No. of Yrs.
Monthly Status of
Name of Company Position Inclusive Dates (Teaching; Non-Teaching; Working
Salary Appointment
Industrial Experience) Exp.
(For more information, indicate on a separate sheet)
8. Other Training/Seminars Attended
8.1. 8.2. 8.3. 8.4. 8.5. 8.6. 8.7. 8.8. 8.9.
Inclusive *Certificate # of Training
Title Venue Category Conducted By Proficiency
Dates Received Hours Base
(For more information, indicate on a separate sheet)
* Certificate Received Training Base Category Proficiency
A Certificate of Attendance S Skills Training Certificate L Local T Trade Skills Upgrading Program B Beginner
c Certificate of Competencies T Training Certificate F Foreign N Non-Trade Upgrading Program I Intermediate
P Certificate of Proficiency M Training Management A Advanced
9. Licenses/Examinations Passed
9.1. 9.2. 9.3. 9.4. 9.5. 9.6.
Title Year Taken Examination Venue Rating Remarks Expiry Date
(For more information, indicate on a separate sheet)
10. Competency Assessment Passed
10.1. 10.2. 10.3. 10.4. 10.5. 10.6.
Industry Sector Trade Area Occupation Classification Level Competency Specialization Description
(For more information, indicate on a separate sheet)
11. Family Background
11.1. Spouse’s Name: 11.3. Occupation:
11.2. Educational Attainment: 11.4. Ave. Monthly Income:
11.5. Father’s Name: 11.7. Occupation:
11.6. Educational Attainment: 11.8. Ave. Monthly Income:
11.9. Mother’s Name: 11.11. Occupation:
11.10. Educational Attainment: 11.12. Ave. Monthly Income:
11.13. Name of Guardian: 11.15. Occupation:
11.14. Educational Attainment 11.16. Ave. Monthly Income:
11.17. Dependents 11.18. Age Dependent Age
(For more information, indicate on a separate sheet)
