SMU EMPLOYEE INFORMATION SHEET (v2)

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
Email Address*
example@smu.edu.ph
Phone Number*
Maximum of two cellphone numbers
Date of Birth
MonthDayYear
Date
Place of Birth
Ethnicity (Dominant)*
Gender*
Blood Type
Current Church Affiliation/Religion*
Confirmed*
Civil Status*
Kindly attach supporting legal documents*
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Name of Spouse*
First NameMiddle InitialLast NameSuffix
His/Her Occupation*
Type of Marriage*
Wedding Date*
MonthDayYear
Date
Church of Marriage*
Name of Church
Place of Marriage*
Address
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:*
School Name School Address Month & Year of Graduation
Grade School
High School
Senior High School
B. UNDERGRADUATE STUDIES (Bachelor's Degree)*
Degree Major/Minor School Address S.O. Number Month & Year of Graduation Honors Received
1
2
3
4
C. GRADUATE STUDIES (Masters/Doctorate Degrees) *
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*
Studies Institution Inclusive Dates
1
2
3
4
5
6
7

3. PROFESSIONAL BOARD/BAR EXAMINATIONS
(Type N/A if Not Applicable)
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Has your professional certificate ever been revoked, cancelled or suspended?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*

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

B. COLLEGIATE LEVEL*

	Position/s Held	Institution	Address	Inclusive Dates (Month/Day/Year)	Status
1
2
3
4
5
6
7

C. HIGH SCHOOL LEVEL *

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

D. GRADE SCHOOL LEVEL*

	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.*

	Position/s Held	Agency/ Institution	Address	Inclusive Dates (Month/Day/Year)	Status
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

7. PROFESSIONAL BOOKS or ARTICLES AUTHORED and PUBLISHED
(Type N/A if Not Applicable)
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)
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!
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10. AFFILIATIONS/MEMBERSHIP TO PROFESSIONAL ORGANIZATIONS
(Type N/A if Not Applicable)
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

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)
NAME
(First Name Middle Initial Last Name)
RELATIONSHIP
1
2
3
4
5

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*
Clear
Signed on
MonthDayYear
Date
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.*
Got it.
Should be Empty:

	NAME (First Name Middle Initial Last Name)	CURRENT ADDRESS
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	NAME (First Name Middle Initial Last Name)	BIRTHDATE (MM / DD / YYYY)
1
2
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8

1. PERSONAL INFORMATION