WORK EXPERIENCE SHEET
Instructions: 1. Include only the work experiences relevant to the position being applied for.
2. The duration should include start and finish dates, if known, month in abbreviated form,
if known, and year in full. For the current position, use the word Present, e.g., 1998-
Present. Work experience should be listed starting with the most recent/present
employment
Duration: January 30, 2023-March 12, 2023
Position: Teacher I - Substitute
Name of Office/Unit: Filipino Department
Immediate Supervisor: Francis Kenneth D. Hernandez
Name of Agency/Organization and Location: Dasmariñas Integrated High School
List of Accomplishments and Contributions (if any)
Summary of Actual Duties
o Responsible for preparing lessons and PowerPoint Presentation, ensuring the
diversity and equality among the students, making quizzes, computing and encoding
grades and students’ performances, encouraging students’ participation,
communicating with parents about their child’s academic performance, collaborating
with other teachers for the betterment of students’ learning acquiring various
techniques and strategies in teaching, and providing quality of education.
Duration: September 5, 2022-December 4, 2022
Position: Teacher I - Substitute
Name of Office/Unit: English Department
Immediate Supervisor: Francis Kenneth D. Hernandez
Name of Agency/Organization and Location: Dasmariñas North National High School
List of Accomplishments and Contributions (if any)
Summary of Actual Duties
o Responsible for preparing lessons and PowerPoint Presentation, ensuring the
diversity and equality among the students, making examination for the first quarter,
making quizzes and long quizzes, computing and encoding grades and students’
performances, encouraging students’ participation, communicating with parents
about their child’s academic performance, collaborating with other teachers for the
betterment of students’ learning acquiring various techniques and strategies in
teaching, and providing quality of education. Aside from that, giving instructions,
assessing students’ outputs, lesson planning, delivering lessons, conferencing
students and parents, supervising students inside and outside the classroom and
school.
Duration: September 15, 2021 - April 20, 2022
Position: Faculty Member
Name of Office/Unit: High School Department
Immediate Supervisor: Divina G. Oliveros
Name of Agency/Organization and Location: Jesus Son of Mary Academy
List of Accomplishments and Contributions (if any)
Summary of Actual Duties
o Responsible for preparing lessons, making examination every quarter, encouraging
students’ participation, communicating with parents about their child’s academic
performance, collaborating with other teachers for the betterment of students’
learning acquiring various techniques and strategies in teaching, and providing
quality of education.
Duration: June 30, 2020 - May 18, 2021
Position: Advisory Teacher
Name of Office/Unit: Intermediate Department
Immediate Supervisor: Christine Caroline Santos
Name of Agency/Organization and Location: Jabez Christian School
List of Accomplishments and Contributions (if any)
Summary of Actual Duties
o Responsible for preparing lessons, making examination every quarter, encouraging
students’ participation, communicating with parents about their child’s academic
performance, collaborating with other teachers for the betterment of students’
learning acquiring various techniques and strategies in teaching, and providing
quality of education.
Duration: April 22, 2019 - April 22, 2020
Position: Full Time Teacher
Name of Office/Unit: Head Teacher Department
Immediate Supervisor: Karen Kaye Gonzales
Name of Agency/Organization and Location: Kids and Play Tutorial Center
List of Accomplishments and Contributions (if any)
Summary of Actual Duties
Attachment to CS Form No. 212
o Responsible for providing quality of education, facilitating students from different
grade level, assisting students with special needs, acting carefully, and ensuring the
knowledge acquired by the students.
(Signature over Printed Name
of Employee/Applicant)
Date: ______________
June 6, 2023
Elias A. Alicaya, Jr., Ed. D.
Assistant Schools Division Superintendent
OIC, Office of the Schools Division Superintendent
Dear Ms. Alicaya,
I have read from the department’s social media platform that the Department of
Education Dasmariñas is in need of Junior High School Teachers. I have obtained
significant license from Professional Regulation Commission which is one of the main
qualifications for this position. I also have acquire knowledge from Technical Education
and Skills Development Authority – English Proficiency and In-Service Training Program
of PEAC that truly help me to become more effective speaker and teacher.
In my three years of work experience in private schools, I have developed and
acquired various strategies in teaching different grade levels and different capacities. I
have improved my technological skills as I used different educational websites and
games to ensure the learning of the students. In almost a year, I have been a substitute
teacher in Dasmariñas North National High School and in Dasmariñas Integrated High
School. This work experience is an eye-opener for me to see the reality behind my
dream. I have learned working on documents and papers of the students. I have
discovered strategies and techniques on how to effectively impart the lesson to
students. And for that, I believe that quality education should be given to students of
dedicated and passionate teachers.
Attached in this letter are my requirements for a teaching position.
In the meantime, please feel free to contact me at 09279056045 or email me at
diane6398@gmail.com. I would be happy to welcome an interview.
Thank you for your consideration.
Respectfully yours,
Diane G. Matira
Applicant
CS Form No. 212
Revised 2017
PERSONAL DATA SHEET
WARNING: Any misrepresentation made in the Personal Data Sheet and the Work Experi ence Sheet shall cause the fi ling of administrative/criminal ca se/s
against the person concerned.
READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOM PLISHING THE PDS FORM .
Print legibly. Tick appropriate boxes ( ) and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIAT E. 1. CS ID No. (Do not fill up. For CSC use only )
I. PERSONAL INFORMATION
2. SURNAME MATIRA
NAM E EXTENS ION (J R ., S R )
FIRST NAME DIANE N/A
MIDDLE NAME GIDA
3. DATE OF BIRTH
06/03/1998 16. CITIZENSHIP
Filipino Dual Citizenship
(mm/dd/y y y y )
by birth by naturalization
4. PLACE OF BIRTH RI CITY OF DASMARI Ñ AS, CAVITE If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male Female
Single Married 17. RESIDENTIAL ADDRESS BL OCK N-5 LOT 18 N/A
6 CIVIL STATUS
Widowed House/Block/Lot No. Street
Separated
N/A SAN FRA NCISCO 1
Other/s:
Subdivision/Village Barangay
DA SMARIÑAS CAVITE
7. HEIGHT (m) 1.57
City/Municipality Province
8. WEIGHT (kg) 48 ZIP CODE 4114
18. PERMANENT ADDRESS BL OCK N-5 LOT 18 N/A
9. BLOOD TYPE AB
House/Block/Lot No. Street
N/A SAN FRA NCISCO 1
10. GSIS ID NO. N/A
Subdivision/Village Barangay
DA SMARIÑAS CAVITE
11. PAG-IBIG ID NO. 121258783133
City/Municipality Province
12. PHILHEALTH NO. 082545093827 ZIP CODE 4114
13. SSS NO. 0442716509 19. TELEPHONE NO. 046-506-7486
14. TIN NO. 751706369 20. MOBILE NO. 09279056045
15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any ) d iane6398@g m ail .co m
II. FAMILY BACKGROUND
DATE OF BIRTH
22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all)
(mm/dd/y y y y )
NAME EXTENS ION (J R ., S R ) 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 MATIRA
NAME EXTENS ION (J R ., S R )
FIRST NAME RENATO N/A
MIDDLE NAME YL AGAN
25. MOTHER'S MAIDEN NAME
SURNAME GIDA
FIRST NAME EL EANOR
MIDDLE NAME GENABE (Continue on separate sheet if necessary)
III. EDUCATIONAL BACKGROUND
S C HOLAR S HI
P ER IOD OF HIGHES T LEVEL/ YEAR P/
26. NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE
LEVEL ATTENDANC E UNITS EAR NED GR ADUATE AC ADEM IC
(Write in full) (Write in full) (if no t gradua te d) D HONOR S
From To R EC EIVED
MODEL
ELEMENTARY SAN NICOL AS ELEMENTA RY SCHOOL ELEMENTA RY 2005 2011 GRADUAT ED 2011
STUDENT
MODEL
SECONDARY DA SMARIÑAS NATIONAL HIGH SCHOOL HIGH SCHOOL 2011 2015 GRADUAT ED 2015
STUDENT
VOCATIONAL /
N/A N/A N/A N/A N/A N/A N/A
TRADE COURSE
BA CHEL OR OF SECONDARY STUDENT
COLLEGE DE L A SALL E UNIVERSITY-DASMARIÑAS 2015 2019 GRADUAT ED 2019
EDUCATION MAJOR IN ENGL ISH ASSISTA NT
GRADUATE STUDIES N/A N/A N/A N/A N/A N/A N/A
(Continue on separate sheet if necessary)
SIGNATURE DATE
C S FOR M 212 (R ev is ed 2017), P age 1 o f 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 Date of
(If Applicable) NUMBER
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT Validity
LICENSURE EXAMINATION FOR TEACHERS 76.6 09/29/2019 MANILA 1837382 06/03/2023
XXX XXX XXX XXX XXX XXX
(Conti nu e on sep arate 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.
SALARY/ JOB/
28. INCLUSIVE DATES PAY GRADE (if
POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY M ONTHLY GOV'T
(mm/dd/y y y y ) ap p licab le)& S TATUS OF
S ER VIC E
(Write in full/Do not abbrev iate) (Write in full/Do not abbrev iate) S ALAR Y STEP (Fo rmat AP P OINTM ENT
" 0 0 -0 ")/ (Y/ N)
From To INC REM ENT
01/30/2023 03/12/2023 TEACHER I - SUBSTITUTE DASMA RIÑAS INTEGRATED HIGH SCHOOL P27,000 N/A CONTRA CTUA L Y
DASMA RIÑAS NORTH NATIONAL HIGH
09/05/2022 12/04/2022 TEACHER I - SUBSTITUTE P25,439 N/A CONTRA CTUA L Y
SCHOOL
09/15/2021 04/20/2022 FACULTY MEMBER JESUS SON OF MARY ACADEMY P14,000 N/A CONTRA CTUA L N
06/30/2020 05/18/2021 ADVISORY TEACHER JABEZ CHRISTIAN SCHOOL P9,500 N/A CONTRA CTUA L N
04/22/2019 04/22/2020 FULL-TIME TEACHER KIDS AND PLAY TUTORIAL CENTER P8,500 N/A CONTRA CTUA L N
XXX XXX XXX XXX X XX XXX XXX XXX
(Continue on sep ar ate sheet if necessar y)
SIGNATURE DATE
C S FOR M 212 (R e v is e d 2017), P age 2 o f 4
VI. VOLUNTA RY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
NAME & ADDRESS OF ORGANIZATION INCLUSIVE DATES
29. NUMB ER OF
(Write in full) (mm/dd/y y y y ) POSITION / NATURE OF WORK
HOUR S
From To
BARANGAY SAN FRANCISCO 1-YOUTH TASK FORCE 10/09/2014 02/28/2019 N/A YOUTH TASK FORCE - ACTING SANGGUNIANG KABATAAN
BALIK-ARAL VOLUNTEER TEACHER 05/06/2018 07/08/2018 N/A VOLUNTEER TEACHER
XXX XXX XXX XXX XXX
(Con tinue on separ ate sheet if necessary)
VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
(Start fro m the m ost recent L&D/tr ainin g p rogram and include only the relevant L& D/training taken for the last fi ve (5) years for Division Chief/Executive/Managerial positions)
INCLUSIVE DATES OF
Type o f LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ATTENDANCE NUMB ER OF ( M a na geria l/ CONDUCTED/ SPONSORED BY
(Write in full) (mm/dd/y y y y ) HOUR S S upe rvis o ry/ (Write in full)
Te c hnic a l/e tc )
From To
2021 IN-SERVICE TRAINING (INSET) FOR SENIOR HIGH SCHOOL TEACHERS PRIVAT E EDUCAT ION ASSISTANCE
02/28/2022 03/02/2022 24 TECHNICAL
(ADDITIONAL RUNS ONLINE) COMMITT EE
ADVANCE TEACHING STYLES: ENGAGING MODERN LEARNERS USING
03/27/2021 03/27/2021 8 TECHNICAL BRAINTRAIN LEARNING
BRAINTRAINING TECHNIQUES
PRIVAT E EDUCAT ION ASSISTANCE
2020 - IN SERVICE TRAINING (INSET) FOR JUNIOR HIGH SCHOOL TEACHERS 11/02/2020 11/04/2020 24 TECHNICAL
COMMITT EE
BASIC T RAINING COURSE FOR OUTFIT ADVISORS 03/19/2019 03/21/2019 72 TECHNICAL BOY SCOUT OF T HE PHILIPPINES
8TH YOUNG EDUCAT ORS' CONGRESS " EMBRACING STUDENT DIVERSITY" 02/08/2019 02/08/2019 8 TECHNICAL DE LA SALLE UNIVERSITY - DASMARIÑAS
XXX XXX XXX XXX XXX XXXX
(Con tinue on separ ate sheet if necessary)
VIII. OTHER INFORMATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION MEMBERSHIP IN
31. SPECIAL SKILLS and HOBBIES 32. 33.
(Write in full) ASSOCIATION/ORGANIZATION
COMMUNI CATION SKILLS N/A N/A
TECHNOLOGICAL SKILLS
INTERPERSONAL SKILLS
PROBLEM- SOLVING SKILLS
XXX
(Continue on separ ate sheet if necessary)
SIGNATURE DATE
C S FOR M 212 (R e v is ed 2017), P age 3 o f 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:
________________________________
N/A
b. Have you been criminally charged before any court? YES NO
If YES, give details:
________________________________
Date Filed: N/A
Status of Case/s: N/A
36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or
YES NO
regulation by any court or tribunal?
If YES, give details:
________________________________
N/A
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? F IN IS HED C ON TR A C T F R OM D A S M A R IN A S
IN TEGR A TED HIGH S C HOOL
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: N/A
b. Have you resigned from the government service during the three (3)-month period before the YES NO
last election to promote/actively campaign for a national or local candidate? If YES, give details: N/A
39. Have you acquired the status of an immigrant or permanent resident of another country?
YES NO
If YES, give details (country):
N/A
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: N/A
b Are you a person with disability? YES NO
. If YES, please specify ID No: N/A
c Are you a solo parent? YES NO
. If YES, please specify ID No: N/A
41. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)
NAME ADDRESS TEL. NO.
ID picture taken within
the last 6 months
KAREN KAYE GONZALES KIDS AND PLAY TUTORIAL CENTER 09173024996 3.5 cm. X 4.5 cm
(passport size)
CHRISTINE CAROLINE SANTOS JABEZ CHRISTIAN SCHOOL 09175141210 With f ull and handwritten
name tag and signature ov er
printed name
RACHELL H. GUERRERO JESUS SON OF MARY ACADEMY 09333279386
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied picture
is not acceptable
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.P a s s po rt, GSIS, S S S, P RC , Driver's
Lice ns e, e tc.) PLEASE INDICATE ID Number
Gov ernment Issued ID: PRC L ICENSE
ID/License/Passport No.: 1837382
Signature (Sign inside the box )
Date/Place of Issuance: 01/08/2020 - ROBINSONS PA LA-PA LA
Date Accomplished Right Thumbmark
SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.
HON. JENNIFER AUSTRIA-BARZAGA
City Mayor
Person Administering Oath
C S FOR M 212 (R e vis e d 2017), P age 4 o f 4
