CS FORM No. 100 (Revised November 2012) . This Form is NOT for sale. Reproduction is allowed.

APPLICATION NO.

APPLICATION FOR CIVIL SERVICE EXAMINATION

For Processor ONLY
CSC Regional Office

To be filled-out by Applicant
Examination Applied For :
Mode
Paper-and-Pencil Test (PPT)
Computer-Assisted Test (CAT)
Level

CSE-Professional
SubProfessional Others

ID PHOTO

Date of Examination (mm/dd/yyyy)

(see Specifications at
the back)

CSEPlace of Examination

Last Examination Taken : (for Career Service Examination Applicants only)

CSE-SubProfessional

CSE-Professional

Verified against:
DIBAR
E-Retakers

Date of Exam (mm/dd/yyyy)

Instructions : READ ADMISSION AND APPLICATION REQUIREMENTS AT THE BACK PAGE. DO NOT APPLY IF NOT QUALIFIED.
Fill in all the required information. DO NOT leave an item blank. If item is not applicable, indicate N/A.
All applications must be filed PERSONALLY by applicant.
NAME

(Last Name)

(First Name)

OEVS

CSID NO. (if any)

(Ext. Name, i.e. Jr./Sr., if any)

(M.I.)

(Middle Name)

A. FACTS OF BIRTH
AGE

DATE OF BIRTH (mm/dd/yyyy)

SEX
Male

PLACE OF BIRTH

MOTHERS MAIDEN NAME

CITIZENSHIP

(City / Municipality)

(Province)

(Country)

Female
( Last Name)

(Middle Name)

(First Name)

B. CURRENT DEMOGRAPHIC DATA

PERMANENT/MAILING ADDRESS (Room / Floor / Unit No. / Bldg. Name)
(Barangay)
HEIGHT (meters)

(House / Lot / Block / Phase No.)

(City / Municipality)
WEIGHT (kg)

CIVIL STATUS
Single

.
MOBILE NUMBER (Required)

(Street Name)

(Province)

Married

Widowed

(Subdivision)

(Country)

Legally Separated

Annulled

TELEPHONE NUMBER/S (include Area Code)

ZIP CODE

Others

E-MAIL ADDRESS (Required)

C. EDUCATIONAL BACKGROUND
If Not Graduated
Level of Education

Course/Degree Title

Name of School & Address (City/Municipality & Province)

Highest Grade/
Level/ Units
Earned

Year of Last
Attendance

If Graduated
Year
Graduated

Academic Honors
Received

Doctorate
Masters
College
Vocational/Technical
High School
Elementary
D. INFORMATION ON GOVERNMENT EXAMINATIONS PASSED / CIVIL SERVICE ELIGIBILITY
Title of Examination Passed / Title of Eligibility Granted

Rating Obtained

Date of Examination /
Date Eligibility Granted

Place of Examination

Date Accomplished

Signature over Printed Name of Applicant

DO NOT FILL-OUT THE SHADED PORTION. (FOR PROCESSOR ONLY).
Date:

Identification/Other Documents Presented:

O.R. No.

Details:

DISAPPROVED

ACTION TAKEN: APPROVED

Amount:
Reason:
Signature over Printed Name of Processor / Date
Name of Collecting Officer

APPLICATION RECEIPT

Date:
O.R. No.

Examination Applied For:

Amount:

DATE:

Name of Collecting Officer

PPT

CAT

Professional
TIME:

APPLICATION NO.

SubProfessional

Others

PLACE:

Signature over Printed Name of Processor

Date Received / Processed

To be filled-out by Applicant

(see Specifications at
the back)

Applicants Name:
First Name

Sex:

Male

Female

ID PHOTO

Date of Birth (mm/dd/yyyy):

MI

Last Name

Ext. Name (i.e. Jr./Sr., if any)

Signature:

WARNING: The Civil Service Commission uses a highly reliable system to detect cheats. Any form of cheating in any civil service examination shall
be considered a violation of Republic Act No. 9416 (Anti-Cheating Law), and any person found guilty shall be administratively and criminally liable.

~ Please co n tinu e at the Back Page ~

E. PRESENT EMPLOYMENT
Government

Private

Non-government Organization

Agency/Office

Address

Unemployed

Self-Employed
No. of Years in Present
Position/Job

Position/Job Title

Status of Appointment/
Employment

F. OTHER INFORMATION

1. Have you ever been dismissed from the military/civil 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 decision/s.
2.

Pursuant to (a) Indigenous Peoples Act (RA 8371) and (b) Magna Carta for Disabled Persons (RA 7277, as amended),
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:

G. DECLARATION

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. Further, I understand that the acceptance and approval of my application for the examination is based on the aforestated
information.
I therefore agree that, in case a post-verification yields information contrary to what is declared, my application shall be
disapproved, and my payment forfeited. I further 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.
In addition, I agree to undergo a validating examination in case my test results shall be found statistically improbable. Failure on
my part to take the validating examination shall cause the cancellation of my test results.
Note: Spaces for Signature/Printed Name and Right
Thumbmark of applicant should be left blank.
These shall only be accomplished in the
presence of the Administering Officer/CSC
Processor.

Signature over Printed Name of Applicant

Subscribed and sworn to before me this

day of

_, 20

Signature over Printed Name of Administering Officer

5.

6.

_.

Office / Position

A D M I SS ION RE Q UI RE M E N TS

1.
2.
3.
4.

Right Thumbmark

AP P L I C AT I O N R E Q U I R E M E N T S

1.
Must be 18 years of age on the date of filing of application;
2.
Must be Filipino citizen;
Must be of good moral character;
Must have not been convicted by final judgment of an offense or
crime involving moral turpitude, or disgraceful or immoral conduct,
dishonesty, examination irregularity, drunkenness or addiction to
drugs;
Must have not been dishonorably discharged from military service or
dismissed for cause from any civilian positions in the government;
and
For Career Service Examination applicants, must have not taken the
same level of Career Service Examination in less than three (3)
months.
3.

NOTE: Applicants with pending administrative and/or criminal cases

may take the examination and shall be conferred the
eligibility if they successfully pass the same. However, this is
without prejudice to the outcome of their pending cases. If 4.
they are found guilty of grave offenses, their eligibility shall be
forfeited based on the penalties stated in the decision and
pursuant to Section 52 (a) of the Revised Rules on 5.
Administrative Cases in the Civil Service.

Fully accomplished application form (CS Form No. 100 Revised 2012);
Four (4) copies of identical pictures with specifications, as follows:

taken within the last three (3) months prior to filing of application

Philippine passport picture size (4.5 cm x 3.5 cm or 1.78 x 1.38)

colored, with white background and printed on quality photo paper

in standard close-up shot (from shoulder level up with the head and face
occupying at least 80% of the picture and with the name tag positioned at
approximately 1 inch below the chin)

in bare face (without eyeglasses or any accessories that may cover the facial
features and showing left and right ears

taken in full-face view directly facing the camera, with neutral facial expression
and both eyes open

with full and handwritten (not computer-generated) name tag in the format: First
Name, Middle Initial, Last Name, and Extension Name, if any, and signature over
the printed name
Original and photocopy of any valid ID containing applicants clear picture, date of
birth, signature, and signature of the authorized head of the issuing agency such as
Drivers License, SSS ID, GSIS ID, Philhealth ID, current Company/Office ID, current
School ID, Postal ID, BIR ID, Barangay ID, Voters ID, Valid Passport, or Police
Clearance (Note: Any other ID not included in the list shall NOT be accepted)
For applicants without data on their date of birth in their valid ID, original and
photocopy of NSO-issued Birth Certificate or Birth Certificate authenticated/issued by
the Local Civil Registrar (LCR)
Examination fee of Php500 for the CSE-PPT, or Php600 for the CSE-CAT. For fees of
other examinations, please see related Examination Announcement.

REM I N D ERS
A. FOR APPLICANTS OF CSE PAPER-AND-PENCIL TEST (CSE-PPT)
Qualified applicants shall be notified of their school assignment through an Application Receipt or a Notice of School Assignment (NOSA). They can also use the Online Notice of
School Assignment (ONSA) found in the CSC Website (www.csc.gov.ph) to get a print-out of their NOSA. If applicants still do not know their school assignment or cannot get a copy
of their NOSA via internet one (1) week before the examination day, they should visit or call the Regional Office or Field Office where they filed their application to inquire about their
school assignment. Failure to come on your scheduled examination will mean forfeiture of examination fee and slot.

B. FOR APPLICANTS OF CSE COMPUTER-ASSISTED TEST (CSE-CAT)

Failure to come on your scheduled examination will mean forfeiture of examination fee and slot.

IMPORTANT: All personal belongings including cellular phones, calculators, books, and all other electronic and printed materials must be surrendered
to the Room Examiners. Firearms, if any, must also be surrendered to the security guard/designated firearm custodian at the entrance gate of the testing center.
Proper attire should be worn on filing of application form and on examination day. (e.g. NOT IN SLEEVELESS SHIRT/BLOUSE, OR IN SHORT PANTS, OR IN SLIPPERS)

B R I NG T H E F O LL O W I N G O N E X AM INA T ION D A Y
1.
2.

This Application Receipt or Notice of School Assignment

Same valid I.D. presented at the time of filing of application (NO I.D., NO EXAM )

3.
4.

One (1) blue or black ballpen

Lead pencil/s No. 1 or 2 and eraser/s