CLASS B

For Personnel Administration Department Use Only

Preliminary Screening by:
Date of Exam:
Place of Exam :

Result :

Level :

Given by :
Proficiency :
APPLICATION FOR EMPLOYMENT
File Code:
Instructions:
Applicant No.:
1. Please fill out the application form in your own handwriting. Please write legibly.
Expected Monthly Salary:
2. Indicate only work experience and trainings that can be authenticated/documented.
3. Attach the following:
a.Photocopy of Civil Service Eligibility/Board or Bar Rating.(Original to be presented.)
b.Photocopy of Transcript of Records/ (Original to be presented)

Position Applied For: ACCOUNTANT Date Available for Employment: OCTOBER Recent 1X1 I.D. Picture

How did you hear about us? (Please check one) Advertisement Family Friend Jobfair Jobstreet
p
LANDBANK Website Leaflets/Posters Employee Referral:______________ Others: _________________
Last Name First Name Middle Name Nickname: Civil Status:
JIMENEZ ROVIC DERONE ROV SINGLE
Current Address: Permanent Address:
437F, PUROK 6, BARANGAY PUTLOD, JAEN, NUEVA ECIJA BARANGAY PUTLOD, JAEN, NUEVA ECIJA
Place of Birth: Phone No.: Mobile No.: Gender: Religion:
ALIAGA, NUEVA ECIJA 0955-958-9405 MALE CATHOLIC
Citizenship: Email Address: Height: Weight:
■ Filipino Dual rovicderonejimenez@gmail.com 5'6 55 kls
as
If Dual Citizenship, please indicate:____________________________

EDUCATION
Type Inclusive Year Name of School and Address Honors / Awards
2006 2013 PUTLOD ELEMENTARY SCHOOL (JAEN, NUEVA ECIJA) HONORABLE MENTIONED
Elementary
2014 2019 PUTLOD SAN-JOSE NAT'L HIGH SCHOOL (JAEN, NUEVA ECIJA)/ GENERAL DE JESUS COLLEGE (SAN ISIDRO, NUEVA ECIJA) WITH HIGH HONORS
High School
Inclusive Year Name of School and Address Degree / Major Course Honors / Awards
2019 2023 GENERAL DE JESUS COLLEGE (SAN ISIDDRO, NUEVA ECIJA) BACHELOR OF SCIENCE IN MANAGEMENT ACCOUNTING CUM LAUDE
College

Graduate Studies

GOVERNMENT AND PROFESSIONAL EXAMINATION/S

CIVIL SERVICE PROFESSIONAL ELIGIBILITY

Date Place Rating

PROFESSIONAL LICENSE (PRC Board) Date Place Rating

PROFESSIONAL CERTIFICATION
Date Place Rating
(CFA, CIA, CISA, CEFIMS, etc.)

EMPLOYMENT RECORD Present and Past Employment Record (in chronological order, last position first)
(Use additional sheets as necessary.) Dept./Unit of
Assignment / Major
Inclusive Dates Position Employer and Address Basic Salary Functions
SEPTEMBER OF 2022 JANUARY OF 2023 ASSISTANT OF ACCOUNTS PAYABLE SPECIALIST (INTERN) GLOCHEM MARKETING AND RECYLING CORPORATION (SAN ROQUE, SAN ISIDRO, NUEVA ECIJA) ACCOUNTING AND FINANCE DEPARTMENT

TRAININGS Indicate all trainings/seminars attended, special studies taken, scholarships enjoyed
(Use additional sheets as necessary.)
Title of Seminar and Training Where When No. of Training Hours
TESDA (BOOKKEEPING) COLLEGE CITY OF TECHNOLOGY AND TRADE INC. SEPTEMBER 2023 292 HOURS
FAMILY BACKGROUND (Complete the following information.)
Father Mother
ALEXANDER SALONGA JIMENEZ CARMENCITA DERONE JIMENEZ
Name:___________________________________________ Name:______________________________________________
52 48
Age: ___________ Age: ___________
PUTLOD, JAEN, NUEVA ECIJA PUTLOD, JAEN, NUEVA ECIJA
Present Address:___________________________________ Present Address:_____________________________________
FARMER HOUSEWIFE
Occupation:_______________________________________ Occupation:_________________________________________
NOT APPLICABLE NOT APPLICABLE
Employer and Address:_______________________________ Employer and Address:________________________________
NOT APPLICABLE NOT APPLICABLE
College Degree:___________________________________ College Degree:______________________________________
NOT APPLICABLE NOT APPLICABLE
College/University:_________________________________ College/University:____________________________________
NOT APPLICABLE
School Address:___________________________________ NOT APPLICABLE
School Address:______________________________________
Employer and
Name Age Present Address Occupation
Spouse Address
NOT APPLICABLE
Name Age Present Address School or Occupation (for those employed)
(Use additional sheets as necessary.)
Siblings ALEXCEY D. JIMENEZ 20 PUTLOD, JAEN, NUEVA ECIJA GAPAN CITY COLLEGE
ESCARLLET D. JIMENEZ 12 PUTLOD, JAEN, NUEVA ECIJA PUTLOD-SAN JOSE NATIONAL HIGH SCHOOL

Name Age Present Address School or Occupation (for those employed)

(Use additional sheets as necessary.)
Children NOT APPLICABLE

Are you related to any former and/or current official or employee of LANDBANK:
a.) within the third degree of consanguinity (i.e. mother/father, Have you ever been a respondent in any administrative
son/daughter,brother/sister, nephew/niece, uncle/aunt, case or accused of any criminal case? Yes ■ No
grandparent, grandchild)? Yes ■ No If yes, please provide specific details below or in a
If yes, give name/s of relative/s and relationship/s separate sheet.
_________________________________________________ ____________________________________________________
_________________________________________________ ____________________________________________________

b.) within the third degree of affinity (i.e mother-in-law/ ____________________________________________________

father-in-law, son-in-law/ daughter-in-law, brother-in-law/ ____________________________________________________
sister-in-law)? Yes ■ No ____________________________________________________
If yes, give name/s of relative/s and relationship/s Do you have any physical disability or previous sickness?
_________________________________________________ Yes ■ No
_________________________________________________ If yes, please provide specific details below or in a
c.) other relative/s not specified in items a and b? Yes ■ No separate sheet.
If yes, give name/s of relative/s and relationship/s ____________________________________________________
_________________________________________________ ____________________________________________________
_________________________________________________ ____________________________________________________
EXTRA-CURRICULAR / BUSINESS OR COMMUNITY INVOLVEMENT
(Use additional sheets as necessary.)
Position Organization / Event Period
LOCAL CHAPTER PRESIDENT JUNIOR PHILIPPINE INSTITUTE OF ACCOUNTANTS - GENERAL DE JESUS COLLEGE 2022-2023

OTHER INFORMATION
SPECIAL TECHNICAL SKILLS:
COMMUNICATION SKILLS, CREATIVE AND CRITICAL THINKING SKILLS
___________________________________________________________________________________________________
SPORTS, HOBBIES AND INTERESTS: WATCHING DOCUMENTARIES AND INTERVIEWS
___________________________________________________________________________________________________
APPLICANT UNDERTAKING & WAIVER
I understand that this application form does not constitute an offer of employment by the Land Bank of the Philippines and that any offer by the
Personnel Administration Department following submission of this application will be subject to verification of my personal information and sensitive
personal information, previous employment records, court records, community activities or dealings and will be contingent upon my satisfactorily passing
a physical examination by the Bank. Any false information given by me or concealment of relevant personal information or sensitive personal information
may be considered as material misrepresentation and will be a ground for the Bank to terminate my services in case I am employed. Furthermore, I
hereby hold the Bank free from any liability in any manner whatsoever for aggravation of any pre-existing medical condition whether disclosed or not that may
take place during my employment with the Bank.

I hereby knowingly, voluntarily and fully give my consent to the collection, recording, organization, storage, modification, retrieval, use, consolidation, and
such other processing that may be made by the appropriate authorities of the Bank of my personal information, sensitive personal information and/or
privileged information, including but not limited to my personal and family background, educational, employment and professional history, financial and
personal credit status, court and government records, medical findings and all other information that may be relevant to the determination of my physical,
mental and psychological fitness to be employed by, or remain employed in, the Bank and to undertake a particular task or activity inherent or necessary to
the nature of the work or position I may be considered for selection and placement as well as for future personnel movements.

3rd
Witness my signature this _______day OCTOBER
of ______________________ 20____ , in the City of Manila

ROVIC D. JIMENEZ
_______________________________________________
Applicant's Signature Over Printed Name
 ROVIC D. JIMENEZ
Name:_______________________________________
APPLICATION FOR EMPLOYMENT (additional sheet)
EMPLOYMENT RECORD Present and Past Employment Record (in chronological order, last position first)
Dept./Unit of Assignment/
Inclusive Dates Position Employer and Address Basic Salary Major Functions

TRAININGS Indicate all trainings/seminars attended, special studies taken, scholarships enjoyed
No. of Training
Title of Seminar and Training Where When Hours

FAMILY BACKGROUND (Complete the following regarding your family.)

Name Age Present Address School or Occupation (for those employed)

Siblings

Name Age Present Address School or Occupation (for those employed)

Children

EXTRA-CURRICULAR / BUSINESS OR COMMUNITY INVOLVEMENT

Position Organization / Event Period