Technical Education and Skills Development Authority
Pangasiwaan sa Edukasyong Teknikal at Pagpapaunlad ng Kasanayan
NMIS FORM 01A
( For TPIS )
MANPOWER PROFILE FORM
In accomplishing this form, entries in Italicized letters are optional while the rest are mandatory or required information.
ID PICTURE (2x 2 size)
1.2. NMIS Entry Date:
1. To be accomplished by TESDA
RIGHT THUMBMARK
1.1.
NMIS Manpower Code:
2. Manpower Profile
2.1.
Signature
Name: Mailing Address:
DE GUZMAN
Last
MONA LUISA
First
CHAN
Middle
2.2.
BLOCK 1 LOT 24
Number, Street
BRGY. BLOCK 22, PHASE 2
Barangay Province Region
MANDURRIAO
District
ILOILO CITY
City/Municipality
REGION 6
5000
Zip Code P.O. Box No.
2.3. Sex
2.4. Civi l Stat us
Contact Number/s
0928 505 9771 (033) 321-0639
2.5. Employment Type
2.6. Employment Status
Male Female
Single Married Window/er Separated
Employed Self-employed Unemployed Undefined
Casual Contractual Job Order Temporary
Probationary Regular Permanent
If Student Trainee/OJT
3. Personal Information
3.1. Birthdate: 3.2. Birth Place: 3.3. Citizenship: 3.4. Religion: 3.5. Ethnicity: 3.6. Disability: 08 AUGUST 1979 3.7. Height: 3.8. Weight: 3.9. Blood Type: 3.10. SSS No.: 3.11. GSIS No.: 3.13. Distinguishing Marks: 3.12. TIN No.:
4. Educational Background
4.1. School
ASIAN INSTITUTE OF TOURISM, UP, DILIMAN COLLEGE OF BUSINESS ADMINISTRATION, UP DILIMAN
4.2. Educational Level
UNDERGRADUATE
4.3. School Year 1996 2003
OCT 1999
4.4. Degree BS TOURISM MBA 5.4 Monthly Salary
4.5. Minor
4.6. Major
4.7 Units Earned
4.8. Honors Received
5. WORKING EXPERIENCE ( For Trainers, mandatory field 5.5)
5.1. Name of Company 5.2 Position
Program Head/ Faculty
PROGRAM COORDINATOR
POST GRADUATE
2005 5.3
Inclusive Dates
JUNE 2006
5.5 Occupation Type (Teaching; Non-Teaching; Industrial Experience)
5.6 Status of Appointment No. of Yrs. Working Exp.
JBLFMU-Molo, INC.
UP COLLEGE OF LAW, IDR & PDR OFFICES ASIAN INSTITUTE OF TOURISM, UP DILIMAN KALAYAAN RESIDENCE HALL, UP DILIMAN
present
MAY 2006 MAY 2006 APRIL 2005
LECTURER
RESIDENT ASSITANT
JUNE 2005 JUNE 2005 JUNE 2004
29,000 15,000 10,000 5,000
TEACHING NON-TEACHING TEACHING NON-TEACHING
FULL TIME
PERMANENT, PART-TIME PERMANENT, PART-TIME
PART TIME
3.00 1.50 1.50 1.00
NAVITAIRE INTERNATIONAL, LLC.
DEPARTMENT OF TOURISM, KALAW
TRAINING OFFICER/SRA
OJT
JAN 2000 MAR 1999
JULY 2003 JUNE 1999
28,000
INDUSTRIAL EXPERIENCE INDUSTRIAL EXPERIENCE
PERMANENT, FULL TIME
PART-TIME
3.50 0.25
(For more information, indicate on a separate sheet)
6. Training/Seminars Attended
6.1 Title 6.2 Venue 6.3 Inclusive Dates 6.4 *Certificate Received 6.5 # of Hours 6.6 Training Base 6.7 Category 6.8 Conducted By 6.9 Proficiency
(For more information, indicate on a separate sheet) * Certificate Received
A c P Certificate of Attendance Certificate of Competencies Certificate of Proficiency T
SSkills Training Certificate Training Certificate
Training Base LLocal F Foreign
Category TTrade Skills Upgrading Program N Non-Trade Upgrading Program M Training Management
Proficiency BBeginner I Intermediate A Advanced
7. Licenses/Examinations Passed
7.1. Title 7.2 Year Taken 7.3 Examination Venue 7.4 Rating 7.5 Remarks 7.6 Expiry Date
(For more information, indicate on a separate sheet)
8. Skills Specialization
8.1 Industry Sector To be filled up by NMIS 8.2 Trade Area 8.3 Occupation 8.4 Trade Level To be filled up by NMIS 8.5 Competency To be filled up by NMIS 8.6 Specialization Description
(For more information, indicate on a separate sheet)
9. Family Background
9.1. Spouses Name: 9.2. Educational Attainment: 9.5. Fathers Name: RAMON S. DE GUZMAN 9.6. Educational Attainment: BS BIO, MS ZOO, LLb. 9.9. Mothers Name: LUCITA C. DE GUZMAN 9.10. Educational Attainment: BS ChE, MS ChE, PhD (ChE) 9.13. Name of Guardian: 9.14. Educational Attainment 9.17. Dependents 9.18. Age 9.3 Occupation: 9.4 Ave. Monthly Income: 9.7. Occupation: 9.8. Ave. Monthly Income: 9.11. Occupation: 9.12. Ave. Monthly Income: 9.15. Occupation: 9.16. Ave. Monthly Income: Dependents Age
(For more information, indicate on a separate sheet)
