CS FORM No.

100 (Revised 2008) Republic of the Philippines

THIS FORM IS NOT FOR SALE
CIVIL SERVICE COMMISSION
REPRODUCTION IS ALLOWED
Region: _________________ APPLICATION NO. __________
DATE LAST TAKEN:
( mm / dd / yyyy ) For Processor Only:
DATE OF EXAM:
( mm / dd / yyyy )
PLACE OF EXAM:
1. APPLICANT'S NAME (PRINT IN CAPITAL LETTERS)
__________________ __________________________ ________ _____________________ ________ 2. AGE:_________
(LAST NAME) (FIRST NAME) (Name Extension, e.g. Jr., Sr., III) (MIDDLE NAME) (MI)
3. APPLICANT'S MAIDEN NAME: _________________________ __________________________ ____________________
(For Married Women) (FIRST NAME) (MIDDLE NAME) (LAST NAME)
4. COMPLETE MAILING ADDRESS Tel. No:_______________ Cell. No:______________
____________________________________________________________________________________Zip Code
5. CIVIL STATUS: _______________ 6. SEX: Male Female 7. HEIGHT(m.) __________ 8. WEIGHT(kg) _____________
9. BIRTHDATE: 10. BIRTHPLACE : _________________________ 11. CITIZENSHIP: __________
( mm dd yyyy ) (City / Town / Province)
12. HIGHEST EDUCATIONAL ATTAINMENT:
Level of If not graduated,
Education Highest Grade/Year/ Honors Received
Level/Units Earned
13. PRESENT EMPLOYMENT o Government o Private o None
AGENCY/OFFICE ADDRESS POSITION/JOB
STATUS OF APPOINTMENT/
EMPLOYMENT
14. CIVIL SERVICE/BOARD/BAR/EXAMINATIONS PASSED (Use separate sheet if necessary)
Rating Place of Examination
15. Have you ever been dismissed from the service for cause, or found guilty of crime involving moral turpitude, or of infamous, disgraceful or
immoral conduct, drunkenness or addiction to drugs, or of offense relative to or in connection with the conduct of a civil service
examination? YES [ ] NO [ ] If YES, attach copy/ies of decisions.
16. Have you already passed the same level of examination being applied for? YES [ ] NO [ ]
I declare under oath that I personally accomplished this application form, and I hereby certify that the information given are
true, correct and complete statements pursuant to the provisions of pertinent laws, rules and regulations of the Republic of
the Philippines.
I likewise agree that I will subject myself to a validating examination in case the test results in my place of examination are
statistically improbable.
_______________________
Signature of Applicant
Right Thumbmark
Subscribed and sworn to before me this ________ day of __________________ 20 _______.
OFFICE/POSITION
( Do not fill-up this portion. For Processor/s only)
ACTION TAKEN: APPROVED [ ] DISAPPROVED [ ] DATE _____________ _________________________________
Printed Name and Signature of Processor
A P P L I C A T I O N R E C E I P T Application No. _____________
Received the application for the: [ ] CAT [ ] PPT [ ] Prof [ ] Subprof
TIME: ___________________ Printed Name of Processor: _________________________
DATE: _____________________ Signature of Processor: ________________________
PLACE: ___________________________ Date Received/Processed: _________________
Applicant's Printed Name: _____________________________________________________
Birthdate: _____________________________________ Sex: _________________________
Signature: _______________________________________________________________________
- Please see Back Page for Other Important Examination Information -
TITLE OF EXAMINATION APPLIED FOR
- Please see Back Page for Other Important Examination Information -
Academic
Date of
Examination
LENGTH OF EXPERIENCE
IN PRESENT
POSITION/JOB
Name of School Attended and
Address (Write in full)
Graduated not Graduated
TITLE OF EXAMINATION LAST TAKEN
[READ THE EXAMINATION ANNOUNCEMENT. DO NOT APPLY IF YOU
ARE NOT QUALIFIED]
ADMINISTERING OFFICER
(Signature above Printed Name)
WARNING: Impersonation, cheating and other forms of examination irregularity would lead to dismissal from government
____________ service, perpetual bar from taking civil service examinations, disqualification for re-employment in the
____________ government, and/or imprisonment/fine
TO
Inclusive Years
Of Attendance
FROM
Course/Degree
Email add:______________
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4 Passport size (1.5"x
photo taken within
3 months with FULL
Nametag
4 Scanned, computer
generated/enhanced,
photocopied, cutout, and
pictures without nametag
are not accepted

4 Passport size (1.5
photo taken within
3 months with FULL
Nametag
4 Scanned, computer
generated/enhanced,
photocopied, cutout, and
pictures without nametag
are not accepted
DECLARATION:
1. Have you taken the Career Service Examination in less than 3 months?
YES [ ] NO [ ] If NO, please proceed to succeeding questions.
If YES, you are disqualified to take the Career Service Examination (CSE)
at this time. You may take the same level of the CSE after
three (3) months.
2. Have you failed the same level of examination for four (4) times or more?
YES [ ] NO [ ] If NO, please proceed to succeeding questions.
If YES, have two (2) years already lapsed from the date the fourth (4th) failed examination was taken?
If YES, you are qualified to apply for the same level of the CSE and may proceed
to the succeeding questions.
If NO, you are disqualified to apply for the same level of the CSE at this time.
You may apply for the same level of the CSE only after two (2) years
from the date of the fourth (4th) failed examination taken.
3. How many times have you taken the Career Service Examination starting October 7, 2002?
Professional Dates of Exam: ____________ ___________
____________ ____________
Subprofessional Dates of Exam: ____________ ___________
____________ ____________
4. Reasons for taking the Career Service Examination: _________________________________________________________
5. Have you attended review classes in preparation for the examination? ___________________________________________
If YES, what Review Center? ____________________________________________________________________________
Done this __________ day of _______________________, 20_______.
APPLICANT
(Signature over Printed Name)
NOTE : Pursuant to CSC Resolution No. 021279 dated October 7, 2002, the taking of the
Civil Service Professional or Subprofessional Examinations, via Paper and
Pencil (PPT) or Computer-Assisted Test (CAT) shall be once in three (3)
months and up to four (4) times only. Examinees failing on the fourth attempt may
apply for the same level of the Career Service Examination only after two (2) years
from the date of the fourth examination.
OTHER INFORMATION:
1. Pursuant to (a) Indigenous People's Act (RA 8371) ; and (b) Magna Carta for Disabled Persons (RA 7277) , please answer the
following items:
a) Are you a member of any indigenous group? YES [ ] NO [ ]
If YES, please specify:
b) Are you differently abled? YES [ ] NO [ ]
If YES, please specify:
2. Are you willing to work in the Government? YES [ ] NO [ ]
3. If YES, list three (3) preferred Government Agencies:
a)
b)
c)
4. Preferred Position: Preferred Salary:
IMPORTANT
BRING THE FOLLOWING ON EXAMINATION DAY
1. This Application Receipt
A. FOR APPLICANTS OF PAPER AND PENCIL TEST 2. One [1] blue or black ballpen
IF YOU FAIL TO RECEIVE YOUR NOTICE OF ASSIGNMENT FIVE [5] 3. Lead pencil/s no. 2 and eraser/s
DAYS BEFORE THE EXAMINATION, PLEASE VISIT OR CALL THE 4. Valid I.D. Card with photo, signature, birthdate ( if
REGIONAL OFFICE WHERE YOU FILED YOUR APPLICATION TO INQUIRE available), and signature of authorized head of agency
ABOUT YOUR SCHOOL ASSIGNMENT. FOR NCR APPLICANTS, PLEASE (Office/School/Postal ID/Passport/License/BIR/SSS)
VISIT OUR WEBSITE: www.csc.gov.ph. FAILURE TO COME ON YOUR * This should be the same as that presented at
SCHEDULED EXAMINATION WILL MEAN FORFEITURE OF EXAMINATION the time of application.
FEE AND SLOT. * NO I.D., NO EXAM.
Area or Region
once 2x 3x 4x more than 4x
I declare that the abovementioned information are true. I understand that the acceptance and approval of my application for the examination is based on
the abovecited declaration.
I therefore agree that, in case a post-verification yield information contrary to what is declared, my application shall be disapproved and my payment
forfeited.
In addition, I agree that any misrepresentation made in this document may cause the invalidation of the result of this examination and/or the filing of
administrative/criminal case/s against me.
YES [ ] NO [ ]
B. FOR APPLICANTS OF COMPUTER-ASSISTED TEST * DO NOT bring cellular phones & other materials outside
FAILURE TO COME ON YOUR SCHEDULED EXAMINATION WILL MEAN of those above-listed, otherwise , they will be confiscated
FORFEITURE OF EXAMINATION FEE AND SLOT. by the Security Officers. The Commission will not be liable
for the loss or damage of said belongings.
APPLICATION NO. __________
For Processor Only:
DIBAR
E-Retakers
2. AGE:_________
3. APPLICANT'S MAIDEN NAME: _________________________ __________________________ ____________________
(FIRST NAME) (MIDDLE NAME) (LAST NAME)
6. SEX: Male Female 7. HEIGHT(m.) __________ 8. WEIGHT(kg) _____________
10. BIRTHPLACE : _________________________ 11. CITIZENSHIP: __________
Honors Received
13. PRESENT EMPLOYMENT o Government o Private o None
STATUS OF APPOINTMENT/
EMPLOYMENT
Place of Examination
15. Have you ever been dismissed from the service for cause, or found guilty of crime involving moral turpitude, or of infamous, disgraceful or
immoral conduct, drunkenness or addiction to drugs, or of offense relative to or in connection with the conduct of a civil service
I declare under oath that I personally accomplished this application form, and I hereby certify that the information given are
true, correct and complete statements pursuant to the provisions of pertinent laws, rules and regulations of the Republic of
I likewise agree that I will subject myself to a validating examination in case the test results in my place of examination are
DATE _____________ _________________________________
Printed Name and Signature of Processor
- Please see Back Page for Other Important Examination Information -
Academic
WARNING: Impersonation, cheating and other forms of examination irregularity would lead to dismissal from government
____________ service, perpetual bar from taking civil service examinations, disqualification for re-employment in the
____________ government, and/or imprisonment/fine
______________
Passport size (1.5"x2")
photo taken within
months with FULL
Scanned, computer-
generated/enhanced,
photocopied, cutout, and
pictures without nametag
are not accepted
Passport size (1.5"x2")
photo taken within
months with FULL
Scanned, computer-
generated/enhanced,
photocopied, cutout, and
pictures without nametag
are not accepted
If YES, you are disqualified to take the Career Service Examination (CSE)
If YES, have two (2) years already lapsed from the date the fourth (4th) failed examination was taken?
If YES, you are qualified to apply for the same level of the CSE and may proceed
If NO, you are disqualified to apply for the same level of the CSE at this time.
You may apply for the same level of the CSE only after two (2) years
Dates of Exam: ____________ ___________
____________ ____________
Dates of Exam: ____________ ___________
____________ ____________
4. Reasons for taking the Career Service Examination: _________________________________________________________
5. Have you attended review classes in preparation for the examination? ___________________________________________
If YES, what Review Center? ____________________________________________________________________________
1. Pursuant to (a) Indigenous People's Act (RA 8371) ; and (b) Magna Carta for Disabled Persons (RA 7277) , please answer the
BRING THE FOLLOWING ON EXAMINATION DAY
4. Valid I.D. Card with photo, signature, birthdate ( if
available), and signature of authorized head of agency
(Office/School/Postal ID/Passport/License/BIR/SSS)
* This should be the same as that presented at
I declare that the abovementioned information are true. I understand that the acceptance and approval of my application for the examination is based on
the abovecited declaration.
I therefore agree that, in case a post-verification yield information contrary to what is declared, my application shall be disapproved and my payment
forfeited.
In addition, I agree that any misrepresentation made in this document may cause the invalidation of the result of this examination and/or the filing of
administrative/criminal case/s against me.
* DO NOT bring cellular phones & other materials outside
of those above-listed, otherwise , they will be confiscated
by the Security Officers. The Commission will not be liable