DOCUMENTARY REQUIREMENTS

COACHES & ASST. COACHES

CS Form No. 212

PERSONAL DATA SHEET

Revised 2017

WARNING: An y m i sr ep r esen t a t i o n m a d e i n t h e Per so n a l Da t a Sh eet a n d t h e Wo r k Exp er i en ce Sh eet sh a l l ca u se t h e f i l i n g o f a d m i n i st r a t i ve/cr i m i n a l ca se/s

a g a i n st t h e p er so n co n cer n ed .
READ THE ATTACHED GUIDE TO FIL L ING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOM PL ISHING THE PDS FORM .
Print legibly . Tick appropriate box es ( ) and use separate sheet if necessary . Indicate N/A if not applicable. DO NOT ABBREVIAT E. 1. CS ID No. (Do not fill up. For CSC use only )

I. PERSONAL INFORMATION
2. SURNAME
NAME EXTENSION (JR., SR)
FIRST NAME

MIDDLE NAME

3. DATE OF BIRTH
16. CITIZENSHIP Filipino Dual Citizenship
(mm/dd/y y y y )
by birth by naturalization

4. PLACE OF BIRTH If holder of dual citizenship, Pls. indicate country:

please indicate the details.
5. SEX Male Female

Single Married 17. RESIDENTIAL ADDRESS

6 CIVIL STATUS
Widowed Separated House/Block/Lot No. Street
Other/s:
Subdivision/Village Barangay
7. HEIGHT (m)
City/Municipality Province
8. WEIGHT (kg) ZIP CODE

18. PERMANENT ADDRESS

9. BLOOD TYPE
House/Block/Lot No. Street
10. GSIS ID NO.
Subdivision/Village Barangay
11. PAG-IBIG ID NO.
City/Municipality Province

12. PHILHEALTH NO. ZIP CODE

13. SSS NO. 19. TELEPHONE NO.

14. TIN NO. 20. MOBILE NO.

15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any )

II. FAMIL Y BACKGROUND

22. SPOUSE'S SURNAME 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH
(mm/dd/y y y y )
NAME EXTENSION (JR., SR)
FIRST NAME

MIDDLE NAME

OCCUPATION

EMPLOYER/BUSINESS NAME

BUSINESS ADDRESS

TELEPHONE NO.

24. FATHER'S SURNAME

NAME EXTENSION (JR., SR)
FIRST NAME

MIDDLE NAME

25. MOTHER'S MAIDEN NAME

SURNAME

FIRST NAME

MIDDLE NAME (Co n ti n u e o n sep ar ate sh eet i f n ecessar y)

III. EDUCATIONAL BACKGROUND

SCHOLARSHIP/
HIGHEST LEVEL/
26. NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE PERIOD OF ATTENDANCE Y EAR ACADEMIC
LEVEL UNITS EARNED
(Write in full) (Write in full) GRADUATED HONORS
(if not graduated)
From To RECEIVED

ELEMENTARY

SECONDARY

VOCATIONAL /
TRADE COURSE

COLLEGE

GRADUATE STUDIES

(Co n ti n u e o n sep ar ate sh eet i f n ecessar y)

SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 1 of 4
)
Given this 25th day of October 2017 at Mangagoy, Bislig City, Philippines.

OIC-SGOD Chief
DOCUMENTARY REQUIREMENTS
CHAPERONS
OIC-SGOD Chief
 FAQ’s
Who are qualified to become a coach?
Teaching and non-teaching personnel of both
public and private schools.
 FAQ’s
Is there a need for a coach to undergo training /
refresher course yearly?

Yes. A 24 hours relevant training for non-

combative events and 40 hours for combative
events/gymnastics.
 FAQ’s
Is there an age limit for a coach?

It is the discretionary power of the SDS/RD to

impose age limit for coaches.
 FAQ’s
Who will be the authorized signatories of the
following documents of the coaches?
a. Form 212-PDS
b. Sworn Statement/Affidavit

The division/region legal officer/administrative

officer.
 FAQ’s
What is the requirement of the newly hired
teacher/non-teaching employee to become a
coach as to rendered service?

The
 FAQ’s
Is it possible to have a male chaperons?

No. Only female athletes with male coach