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 BERISO
NAME EXTENSION (JR., SR) N/A
FIRST NAME GLECY

MIDDLE NAME AQUINO

3. DATE OF BIRTH
12/24/1989 16. CITIZENSHIP
(mm/dd/yyyy) ✘ Filipino Dual Citizenship
by by
birth naturalization
4. PLACE OF BIRTH SAN ANDRES, CATANDUANES If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female

6 CIVIL STATUS Single ✘ Married 17. RESIDENTIAL ADDRESS REAL

House/Block/Lot No. Street
Widowe Separat
ZONE III
dOther/s: ed
Subdivision/Village Barangay
GARCHITORENA CAMARINES SUR
7. HEIGHT (m) 1.4986
City/Municipality Province
8. WEIGHT (kg) 62 ZIP CODE 4428

18. PERMANENT ADDRESS ALVAREZ, ZONE 6

9. BLOOD TYPE O+
House/Block/Lot No. Street
BINANUAHAN
10. GSIS ID NO. NONE
Subdivision/Village Barangay

11. PAG-IBIG ID NO. NONE CARAMOAN CAMARINES SUR

City/Municipality Province

12. PHILHEALTH NO. 102032869367 ZIP CODE 4429

13. SSS NO. NONE 19. TELEPHONE NO. NONE

14. TIN NO. 379-048-797-000 20. MOBILE NO. 09166877259

15. AGENCY EMPLOYEE NO. NONE 21. E-MAIL ADDRESS (if any) berisoglecy@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME BERISO 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

FIRST NAME RAMON ADRIEL

NAME EXTENSION (JR., SR) N/A BERISO, ADRIENNE ALECS A. 4/2/2021

MIDDLE NAME AVILA

OCCUPATION DRIVING INSTRUCTOR

EMPLOYER/BUSINESS NAME PARTIDO SKILLS TRAINING CENTER

BUSINESS ADDRESS
LTO COMPOUND, AGUINALDO ST., POBLACION, TIGAON,
CAMARINES SUR
TELEPHONE NO. N/A

24. FATHER'S SURNAME AQUINO

NAME EXTENSION (JR., SR) N/A
FIRST NAME RONNIE

MIDDLE NAME OSORIO

25. MOTHER'S MAIDEN NAME

SURNAME ENDICO

FIRST NAME PEÑA

MIDDLE NAME VILLAREÑA (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 GARCHTORENA CENTRAL SCHOOL ELEMENTARY 6/10/1996 4/10/2002 N/A 2002 NONE

SECONDARY SACRED HEART ACADEMY SECONDARY 6/12/2002 4/28/2006 N/A 2006 NONE
VOCATIONAL /

NONE N/A N/A N/A N/A N/A N/A

TRADE
COURSE BACHELOR OF SECONDARY EDUCATION
COLLEGE CARAMOAN COMMUNITY COLLEGE MAJOR IN ENGLISH 6/28/2013 4/1/2017 N/A 2017 NONE

GRADUATE STUDIES NONE N/A N/A N/A N/A N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE FEBRUARY 20,2025

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

PROFESSIONAL TEACHER 75.0 3/17/2024 LEGAZPI CITY 2213950 10/24/2027

(Continue on separate 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.
GOV'T
28. INCLUSIVE DATES SALARY/ JOB/ PAY SERVICE
(mm/dd/yyyy) POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY MONTHLY GRADE (if STATUS OF
(Write in full/Do not (Write in SALARY
applicable)& STEP
APPOINTMENT
abbreviate) full/Do not abbreviate) (Format "00-0")/
INCREMENT
From To (Y/ N)

1/18/2021 6/9/2024 ADMINISTRATIVE FILING CLERK PARTIDO SKILLS TRAINING CENTER 8000.00 N/A N/A N

6/18/2016 12/30/2020 BARANGAY SECRETARY BARANGAY HALL 4500.00 N/A N/A N

(Continue on separate sheet if necessary)

SIGNATURE DATE FEBRUARY 20, 2025

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

NONE N/A N/A N/A N/A

(Continue on separate sheet if necessary)

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

COMPUTER UPSKILLS TRAINING: ICT INTEGRATION IN CURRICULUM AND INSTRUCTION 7/8/2024 7/19/2024 96.0 TECHNICAL EDTECH TEACHER TRAINING CENTER

(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)

LEARNING N/A N/A

VIDEOGRAPHY

COOKING

SINGING

TRAVEL

DANCE

ADAPTABILITY
(Continue on separate sheet if necessary)

SIGNATURE DATE FEBRUARY 20, 2025

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 ✘

b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘

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 regulation
by any court or tribunal? YES ✘ NO
If YES, give details:
________________________________
N/A
________________________________
37. Have you ever been separated from the service in any of the following modes: resignation,
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract or phased YES ✘ NO
out (abolition) in the public or private sector? If YES, give details:
________________________________
N/A
________________________________
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: N/A
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: 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
PRINCESS KAREN H. BERJA CARAMOAN, CAMARINES SUR 9513143018 4.5 cm. X 3.5 cm
(passport size)
ANGIELI E. AVINADO GARCHITORENA, CAMARINES SUR 9215952267
Computer generated
or photocopied picture
MA. ANA M. BERGUNIO GARCHITORENA, CAMARINES SUR 9124156650 is not acceptable

42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and
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
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: PRC ID

ID/License/Passport No.: 2213950

Signature (Sign inside the box)

Date/Place of Issuance: 07/17/2024 / PRC ROBINSON, NAGA 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