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 ALLES
NAME EXTENSION (JR., SR)
FIRST NAME KRISTELLE MAE

MIDDLE NAME TALANIA

3. DATE OF BIRTH
08/25/2000 16. CITIZENSHIP Dual
(mm/dd/yyyy) ✘ Filipino
Citizenship
by by
birth naturalization
4. PLACE OF BIRTH MALOLOS, BULACAN If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘
Female
6 CIVIL STATUS ✘ Single 17. RESIDENTIAL ADDRESS
Married House/Block/Lot No. Street
Widowe Separa
BANOG NORTE
d ted
Other/s: Subdivision/Village Barangay

7. HEIGHT (m) 1.52 BANI PANGASINAN

City/Municipality Province
8. WEIGHT (kg) 54 ZIP CODE

18. PERMANENT ADDRESS

9. BLOOD TYPE O
House/Block/Lot No. Street

10. GSIS ID NO. N/A BANOG NORTE

Subdivision/Village Barangay

11. PAG-IBIG ID NO. N/A BANI PANGASINAN

City/Municipality Province

12. PHILHEALTH NO. 05-251012126-0 ZIP CODE 2407

13. SSS NO. N/A 19. TELEPHONE NO. N/A

14. TIN NO. N/A 20. MOBILE NO. 0991-698-8330

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

FIRST NAME N/A

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

MIDDLE NAME N/A N/A N/A

OCCUPATION N/A N/A N/A

EMPLOYER/BUSINESS NAME N/A N/A N/A

BUSINESS ADDRESS N/A N/A N/A

TELEPHONE NO. N/A N/A N/A

24. FATHER'S SURNAME ALLES N/A N/A

FIRST NAME NEIL

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

MIDDLE NAME JUANICO N/A N/A

25. MOTHER'S MAIDEN NAME N/A N/A

SURNAME TALANIA N/A N/A

FIRST NAME MARICEL N/A N/A

MIDDLE NAME AVENDAÑO (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

VALEDICTORIA
ELEMENTARY APORAO ELEMENTARY SCHOOL ELEMENTARY 2006 2012 N/A 2012 N

GARRITA NHS (JHS)/BANI EAST INTEGRATED

SECONDARY
SCHOOL (SHS)
HIGH SCHOOL 2012 2018 N/A 2018 WITH HONORS
VOCATIONAL /

N/A N/A N/A N/A N/A N/A N/A

TRADE PROVINCIAL
COURSE PANGASINAN STATE UNIVERSITY-ALAMINOS CITY BACHELOR OF SECONDARY EDUCATION SCHOLARSHIP
COLLEGE CAMPUS MAJOR IN ENGLISH 2018 2022 N/A 2022 PROGRAM

GRADUATE STUDIES

(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

LICENSURE EXAMINATION FOR TEACHERS 80.4 03/19/2023 BAYAMBANG, PANGASINAN 2084056 08/25/2026

(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)

11/10/2024 Present ESL Teacher 91 Speak 8000.00 N/A Casual No

10/11/2024 11/09/2024 Substitute Teacher I Banog Sur National High School 28000.00 N/A Contractual Yes

10/17/2023 10/10/2024 ESL Teacher 91 Speak 8000.00 N/A Casual No

05/19/2023 07/16/2023 Tutor UpKidz Philippines 5000.00 N/A Contractual No

(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

(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

Innovate to Elevate 2.0: Maximizing Impact and Strategies for Your Innovations 03/02/2024 03/02/2024 4.0 Foundation SEAMEO SEN

Guideposts to Happiness and Wholeness: A Conversation with New Teachers 10/28/2023 10/28/2023 2.0 Foundation Philippine Association For Teachers and Educators
(PAFTE) INC.

Professionalism in the Workplace 10/21/2023 10/21/2023 2.0 Foundation Philippine Association For Teachers and Educators
(PAFTE) INC.

What Your Laws Do Not Teach You: Law 101 for Teachers 10/21/2023 10/21/2023 2.0 Foundation Philippine Association For Teachers and Educators
(PAFTE) INC.

Creating Safe Spaces for Learners 10/07/2023 10/21/2023 2.0 Foundation Philippine Association For Teachers and Educators
(PAFTE) INC.

The Art and Style of Handling Parent Teacher Conferences 10/07/2023 10/07/2023 2.0 Foundation Philippine Association For Teachers and Educators
(PAFTE) INC.

Teaching English as a Foreign Language 09/29/2023 10/13/2023 120.0 Foundation Teacher Record

Teacher Excellence in the Post-Pandemic Era 09/23/2023 09/23/2023 2.0 Foundation Philippine Association For Teachers and Educators
(PAFTE) INC.

Lifelong Learning: Embracing Growth and Excellence 09/23/2023 09/23/2023 2.0 Foundation Philippine Association For Teachers and Educators
(PAFTE) INC.

Designing Performance Tasks and Rubrics 09/16/2023 09/16/2023 2.0 Foundation Philippine Association For Teachers and Educators
(PAFTE) INC.

Establishing Linkages with Professional Organizations and The Wider Community 09/16/2023 09/16/2023 2.0 Foundation Philippine Association For Teachers and Educators
(PAFTE) INC.
EMP Memorial Lecture 2023: Filipino Students' Desires for English; Linguistic 09/16/2023 09/16/2023 2.0 Foundation Ateneo De Manila University
Entrepreneurship in the Philippines

Microsoft Digital Literacy 08/30/2023 09/13/2023 9.0 Technical TESDA

English for Career Development 08/09/2023 09/12/2023 25.0 Foundation U.S. Depertment of State MOOC

Multilingual Education in the Philippines: Trends, Issues, Prospects 04/13/2023 04/13/2023 2.5 Foundation Far Eastern University, Institute of Education

(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)

Singing Pangasinan Provincial Scholar Philippine Association for Teacher Education

(PAFTE)

Dancing CHED Scholar

Reading

Watching documentaries

(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 ✘

b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘
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,
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:
________________________________
________________________________
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
Erwin M. Cabildo Jr, LPT Bani, Pangasinan 9919221785 4.5 cm. X 3.5 cm
(passport size)
Luisa Andrea C. Junio, RL Basista, Pangasinan 9566196643
Computer generated
or photocopied picture
Mary Ann Jacinta M. Soriano, RL, MaEd Binmaley, Pangasinan 9611447381 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 ([Link], GSIS, SSS, PRC, Driver's License, etc.)

PLEASE INDICATE ID Number and Date of
Issuance
Government Issued ID: PRC

ID/License/Passport No.: 2084056

Signature (Sign inside the box)

Date/Place of Issuance: Calasiao, Pangasinan

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