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 BANTILAN
NAME EXTENSION (JR., SR)
FIRST NAME CHERYL

MIDDLE NAME VALLECER

3. DATE OF BIRTH
(mm/dd/yyyy) 4/24/1989 16. CITIZENSHIP
✘ Filipino Dual Citizenship
✘ by birth by naturalization
4. PLACE OF BIRTH SAN RAFAEL MABINI BOHOL If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female

6 CIVIL STATUS Single ✘ Married 17. RESIDENTIAL ADDRESS

Widowed House/Block/Lot No. Street
Separated
KAWITDOS BRGY 1 POBLACION
Other/s:
Subdivision/Village Barangay

7. HEIGHT (m) 5'2 DAPA, SIARGAO ISLAND SURIGAO DEL NORTE

City/Municipality Province
8. WEIGHT (kg) 55 kilos ZIP CODE 8417
18. PERMANENT ADDRESS
9. BLOOD TYPE AB+
House/Block/Lot No. Street

10. GSIS ID NO.

Subdivision/Village Barangay

11. PAG-IBIG ID NO. 8301-3748-7111

City/Municipality Province

12. PHILHEALTH NO. 12-051086092-1 ZIP CODE

13. SSS NO. 08-1932310-1 19. TELEPHONE NO.

14. TIN NO. 421-859-053 20. MOBILE NO. 09487446938/ 09153811496

15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any) cherylvallecerbantilan@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME BANTILAN 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

FIRST NAME OSEAS

NAME EXTENSION (JR., SR) ETHAN COVB V. BANTILAN 08/19/2017

MIDDLE NAME PAÑA NATHAN COVB V. BANTILAN 12/22/2018

OCCUPATION Government Employee THANNIAH CHEO V. BANTILAN 2/15/2022

EMPLOYER/BUSINESS NAME Province of Surigao del Norte

BUSINESS ADDRESS Surigao City, Surigao del Norte

TELEPHONE NO.

24. FATHER'S SURNAME VALLECER

FIRST NAME SILVERIANO

MIDDLE NAME NAÏVE

25. MOTHER'S MAIDEN NAME

SURNAME EWAY

FIRST NAME FEVY

MIDDLE NAME BANATE (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

ELEMENTARY
SIBAGAT CENTRAL ELEMENTARY ELEMENTARY 1996 2002 2002 7th Honorable
SCHOOL Mention

SECONDARY SAN ROQUE NATIONAL HIGH SCHOOL SECONDARY 2002 2006 2006 With Honor
VOCATIONAL /

TRADE
COURSE CARAGA STATE UNIVERSITY
COLLEGE
CABADBARAN CITY
BACHELOR IN TOURISM TECHNOLOGY 2008 2012 2012 Cumlaude

GRADUATE STUDIES
LYCEUM OF THE PHILIPPINES - PHD IN INTERNATIONAL HOSPITALITY & 2024 ON GOING
BATANGAS TOURISM MANAGEMENT
(Continue on separate sheet if necessary)

SIGNATURE DATE CS FORM 212 (Revised 2017), Page 1 of 4

IV. CIVIL SERVICE ELIGIBILITY
27. LICENSE (if applicable)
CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER RATING DATE OF
SPECIAL LAWS/ CES/ CSEE (If Applicable) EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT NUMBER Date of
Validity

HONOR ELIGIBILITY 2012 BUTUAN CITY

(Continue on separate sheet if necessary)

V. WORK EXPERIENCE GOV'T
SALARY/ SERVICE
(Include private employment. Start from your recent work) Description of duties should be indicated in the attached Work Experience sheet.
JOB/ PAY
28. INCLUSIVE DATES DEPARTMENT / AGENCY / OFFICE / GRADE (if
(mm/dd/yyyy) POSITION TITLE COMPANY MONTHLY applicable)& STATUS OF
(Write in full/Do not SALARY STEP APPOINTMEN
(Write in full/Do not abbreviate) abbreviate) (Format "00- T
From To 0")/
Program Head, BSTM/TVET Merchant Marine Academy of INCREMEN
06/20/2024 Present 20,000 T (Y/ N)
Coordinator Caraga,Inc
5/2/2019 06/30/2023 PROGRAM HEAD, BSTM Siargao Island Institute of Technology 20,000

4/15/2017 4/15/2019 SHS TEACHER Agusan Del Sur Colleges, Inc 11,000

5/15/2016 5/31/2017 INSTRUCTOR Saint Joseph Institute of Technology 10,000

6/17/2015 6/31/2016 LECTURER Caraga State University Cabadbaran Campus 18,000

4/6/2015 6/15/2015 JOB ORDER LGU Sibagat - Tourism Office 4000.00

10/1/2014 02/30/2015 TECHNICAL ASSISTANT Commission on Human Rights- Butuan City 10000.00 PROJECT

4/16/2012 9/30/2014 TRAVEL CONSULTANT Travelite Travel & Tours 8000.00

(Continue on separate sheet if necessary)

SIGNATURE DATE 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

The Fraternal Order of Eagles (Philippine Eagles) 2024 Present Lady Eagles Club Member

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED

(Start from the most recent L&D/training program and include only the relevant L&D/training taken for the last five (5) years for Division Chief/Executive/Managerial positions)

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

TOUR GUIDING SERVICES NCII 196Hours TESDA

FRONT OFFICE SERVICES NCII 436Hours TESDA

EVENTS MANAGEMENT NCIII 108Hours TESDA

TRAINERS METHODOLOGY (TRAINERS ASSESSOR) LEVEL I 264Hours TESDA

NTTC IN FRONT OFFICE SERVICES NC II

NTTC IN FRONT EVENTS MANAGEMENT SERVICES NC III

NTTC IN TOUR PACKAGES ADHOC NCII

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES 32. NON-ACADEMIC DISTINCTIONS / RECOGNITION (Write in full) 33.
(Write in full)

Associations of Administrators in Hospitality Hotel &

Basic Skirting Restaurant Management Educational Institutions
(AAHRMEI)

Intrapersonal Skills Caraga Council of Tourism Deans & Educators

(CCDTE)
Council of Hotel & Restaurant Educators in the
Philippines (COHREP)
Caraga Associations of Tour Guides
(CARTOGA)

(Continue on separate sheet if necessary)

SIGNATURE DATE 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:
________________________________

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
by any court or tribunal? YES ✘ NO
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? ________________________________
looking for greener pasture
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except
Barangay election)? YES ✘ NO
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
RUEL LADRES BUTUAN CITY 9174892454 3.5 cm. X 4.5 cm
(passport size)
DR. JANE PADEROG BAYUGAN CITY 9100911201 With full and handwritten
name tag and signature over
printed name
DR. DANILO DANIELO OZAMIS CITY 9479944349
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
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the is not acceptable
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
administrative/criminal case/s against me. PHOTO

Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)

PLEASE INDICATE ID Number and Date of Issuance

Government Issued ID: SSS

ID/License/Passport No.: 08-1932310-1

Signature (Sign inside the box)

Date/Place of Issuance: Butuan 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