Office of The Assistant Chief of Staff For Personnel, G1: Camp O'Donnell, Brgy Sta Lucia, Capas, Tarlac
Office of The Assistant Chief of Staff For Personnel, G1: Camp O'Donnell, Brgy Sta Lucia, Capas, Tarlac
Office of The Assistant Chief of Staff For Personnel, G1: Camp O'Donnell, Brgy Sta Lucia, Capas, Tarlac
I - PERSONAL DATA
First Middle Surname
Name: Adrian
(MM/DD/YY)
Birth Date: Age: Sex: Tribe:
Region:
Birth Place:
Civil Status: Citizenship: Dialects:
Height: Weight: Skills:
Home Address:
Present Address:
II - EDUCATIONAL DATA
(Name of School) (Date Graduated)
Elementary:
(Name of School) (Date Graduated)
High School:
College:
Course:
_______________________________________________________________
____
No. of Units:
_________________________________________________________
______
Name of School:
_________________________________________________________
___ Date Graduated:
_________________________________________________________
___
Vocational Course (if any):
Course Taken:
_________________________________________________________
____ Date Graduated:
Civil Service Eligibility/Licensure:
Basic
ROT CM
CMT/ROTC Training: POTC Grad. C. T
Honors Received:
III - FAMILY DATA
Father’s Name: Age:
Occupation:
Address:
Mother’s Name: Age:
Occupation:
Address:
List Three (3) Character References (who are not you relatives)
Name Occupation Complete Home
Address
1.
2.
3.
Please answer the following questions:
1. Have you previously applied for any position in the PA? If yes, why were you not considered?
________________________________________________________________________________ 2. Do you have
any relative in the military? If yes, please indicate full name, rank and unit.
________________________________________________________________________________ 3. What/Who
motivated you to join the service?
________________________________________________________________________________
Middle Name
Last Name
Birth Place
Birthday
Age
Skill
Level of Education
Course
CP Nr
Home Address
Region
Religion
Tribe
Blood Type
CP Nr
AFPSAT Result
Code
Endorser
BDU Size
Athletic Shoes
Tshirt
Short Pants
Height
Tin Nr:
Pag-ibig Nr:
Phil Health Nr
TABLEOFCONTENTS
A. Whole Body Picture (3R)
H. AFPSAT Result with dry seal (if possible attached code number)
J. PFT Result
R. CENOMAR (PSA Certified) with OR must be current & w/in 3 months before
validation period