SMU EMPLOYEE INFORMATION SHEET

1. PERSONAL INFORMATION
(Type NA if Not Applicable)
Employee ID Number
Name
PrefixFirst NameMiddle NameLast NameSuffix
Home Address
House No./ Purok/ Sreet/ Barangay
Street Address Line 2
Town/CityProvince
Postal / Zip Code
Bayombong Address
House No./ Purok/ Sreet/ Barangay
Street Address Line 2
Town/CityProvince
Postal / Zip Code
Corporate Email Address
example@smu.edu.ph
Personal Email Address
example@gmail.com
Messenger Account Name
Phone Number
Maximum of two cellphone numbers
Date of Birth
MonthDayYear
Place of Birth
Ethno-linguistic Affiliation (Dominant)
(Kindly indicate your Ethno-linguistic Affiliation if it is not included in the drop down list)
Sex
Special Equity Group
Blood Type
Current Church Affiliation/Religion
Confirmed
Civil Status
Kindly attach supporting legal documents
Browse Files
Cancelof
Name of Spouse
First NameMiddle InitialLast NameSuffix
Occupation
Type of Marriage
Wedding Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name of Church
Name of Church
Place of Wedding
Address
Emergency Contact Person
First NameMiddle InitialLast NameSuffix
Relationship
Phone Number
Maximum of two cellphone numbers
GOVERNMENT ISSUED IDs
T.I.N. No.
SSS No.
PAGIBIG No.
PhilHealth No.

2. EDUCATIONAL PREPARATION
(Type N/A if Not Applicable)
A. GRADE SCHOOL/ SECONDARY EDUCATION:
Rows School Name School Address Month & Year of Graduation
Grade School
High School
Senior High School
B. UNDERGRADUATE STUDIES (Bachelor's Degree)
Rows Degree Major/Minor School Address S.O. Number Month & Year of Graduation Honors Received
1
2
3
4
C. GRADUATE STUDIES (Masters/Doctorate Degrees)
Rows Degree Major/Minor School Address S.O. Number Month & Year of Graduation Honors Received
1
2
3
4
D. SPECIAL STUDIES COMPLETED, relevant to your position at Saint Mary's University
Rows Studies Institution Inclusive Dates
1
2
3
4
5
6
7

3. PROFESSIONAL BOARD/BAR EXAMINATIONS
(Type N/A if Not Applicable)
Rows Examination Certificate/ Reg. No. Date Passed
(Month & Year)
Rating Remarks
1
2
3
4
Has your professional certificate ever been revoked, cancelled or suspended? *
If yes, state if reinstated *

A. GRADUATE LEVEL

Rows	Position/s Held	Institution	Address	Inclusive Dates (Month/Day/Year)	Status
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2
3
4
5

B. COLLEGIATE LEVEL

Rows	Position/s Held	Institution	Address	Inclusive Dates (Month/Day/Year)	Status
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7

C. HIGH SCHOOL LEVEL

Rows	Position/s Held	Institution	Address	Inclusive Dates (Month/Day/Year)	Status
1
2
3
4
5

D. GRADE SCHOOL LEVEL

Rows	Position/s Held	Institution	Address	Inclusive Dates (Month/Day/Year)	Status
1
2
3
4
5

List of experiences starting with the least recent and include only FULL- TIME professional work experiences.

Rows	Position/s Held	Agency/ Institution	Address	Inclusive Dates (Month/Day/Year)	Status
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2
3
4
5
6
7
8
9
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12
13
14
15

7. PROFESSIONAL BOOKS or ARTICLES AUTHORED and PUBLISHED
(Type N/A if Not Applicable)
Rows Title Publisher/Publication Volume/Year
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30

8. AWARDS RECEIVED (Regional, National and International)
(Type N/A if Not Applicable)
Rows Name of Award Date Awarded Place Awarding Body
1
2
3
4
5
6
7
8
9
10
Kindly attach proof of received award/s. Thank you!
Browse Files
Cancelof

10. AFFILIATIONS/MEMBERSHIP TO PROFESSIONAL ORGANIZATIONS
(Type N/A if Not Applicable)
Rows Name of Organization Position Held Inclusive Dates
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30

11. TRAININGS, SEMINARS and CONFERENCES ATTENDED
(To be provided by HRDO based on the Trainings/Seminars/Conferences attended that were submitted via Jotform)

Failure to Nominate.
If at the death of the SMU employee, there is no existing valid nominated beneficiary, the existing laws on succession shall prevail.
12. NOMINATED BENEFICIARIES
(Death Benefits/ Burial Assistance)
Rows NAME
(First Name Middle Initial Last Name)
RELATIONSHIP
1
2
3
4
5
6

DECLARATION
I hereby declare, under penalties of perjury, that the answers/data given are true and correct to the best of my knowledge and belief.
Signature
Signed on
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
NOTE: A rough rendition of your signature will suffice.

DATA PRIVACY NOTICE
We are committed to protect your privacy and ensure that all personal data collected are processed according to the principles of transparency, legitimate purpose, and proportionality pursuant to R.A. 10173 (Data Privacy Act of 2012). The personal data collected herein will be used for the purpose of validating and updating your FILE 201 (Personnel Information) and for accreditation purposes.
Should be Empty:

Rows	PATERNAL SIBLINGS (First Name Middle Initial Last Name)	MATERNAL SIBLINGS (First Name Middle Initial Last Name)
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9
10
11
12
13

Rows	NAME (First Name Middle Initial Last Name)	CURRENT ADDRESS
1
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8
9
10
11
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13

Rows	NAME (First Name Middle Initial Last Name)	BIRTHDATE (MM / DD / YYYY)
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2
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5
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7
8

1. PERSONAL INFORMATION