Government
Private
Non-government Organization
Agency/Office
Address
Unemployed
Self-Employed
No. of Years in P resent resent Position/ Position/JJ ob
P osition/J ob Title
Status of Appointment/ Employment
1. Have you ever been dismissed dismissed from the military/civil military/civil service for cause, cause, or found guilty of crime involving moral turpitu turpitude, de, or of infam infamous, ous, disgraceful or immoral conduct, drunkenness or addiction to drugs, or of offense relative to or in connection with the conduct of a civil service examinat examination? ion? YES NO IF YES, attach copy/ies of decision/s. 2.
P ursuant to (a) Indigenous People’s Act (RA 8371) and and (b) Magna Carta for Disabled Persons (RA 7277, as amended), please answer the following items: items: a) Are you a member of any indigenous group?
YES
NO
If YES, pleas lease e spe specif cify: ____ ____ ___ ___ ____ ___ ___ ____ ___ ____ ____ ___ b) Are you a person with with disability? disability?
Y ES
NO
If YES, please ease spec speciify: ___ ____ ____ ____ ___ ____ ___ ___ ____ ___ ___ ____
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 Philipp ines. Further, I understand th at the acceptance and and approval of my applicatio n for the examination 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 disappr oved, and and my payment forfeited. I furth er agree agree that any misrepresentation made in this docu ment may cause the invalidation of the result of this examination and/or the filing of administrative/criminal case/s against me. In additi additi on, I agree to underg o a validating examinatio n in case my test results shall be found statistic ally impro bable. Failure on my part to take the validating examination shall cause the cancellation of my test results. Note: Spaces for Signature/Printed Name Name and Right Thumbm ark 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
Right Thumbmark
Subscribed and sworn to before me this ________ day of ______________________________, 20 ______. ___ ____ __ _____ ___ ____ __ ____ ____ _____ ___ ____ __ ____ ____ ____ _____ ___ ____ __ ____ _____ ___ ___ __
_____ __ ___ ___ ____ __ _____ ___ ___ ____ __ _____ ___ ___
Signature over Printed Name of Administering Officer
Office / Position
A D M I S S I O N R E Q U I R E M E N T S
1. 2. 3. 4.
5. 6.
A PPL ICA TION REQUIREMENTS
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 judgment of an offense 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 discharged from military service service or dismissed for cause from any civilian positions in the government; and and F or Career Service Examination Examination applicants, applicants, must must have have not 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 eligibility if they they successfully pass the same. However, this this is without prejudice to the the outcome outcome of their 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 F orm No. 100 100 Revised 2012); 2012); Four (4) copies of of identical identical pictures pictures with specifications, as follows: follows: taken within the last three (3) months prior to filing of application P hilippine passport pas sport picture size si ze (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 L ast Name, and Extension Name, if any, and signat s ignature ure over the printed name Original Origi nal and photocopy of any valid ID containing applicant’s clear picture, date of birth, signature, and signature of the authorized head of the issuing agency such as Driver’s License, SSS ID, GSIS ID, Philhealth ID, current Company/Office ID, current School ID, Postal ID, BIR ID, Barangay ID, Voter’s ID, Valid Passport, or Police Clearance (Note: Any other ID not included included in the list shall NOT be accepted) accepted) For Fo r applicants without without data on their their date of birth in their 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 P hp500 for the CS E-P P T, or P hp600 for the CS E-C AT. For fees fees of other examinations, please see related Examination Announcement. • • • •
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REMINDERS A. FOR APPLICANTS OF CSE PAPER-AND-PENCIL TEST (CSE-PPT) (CSE-PPT) Qualified applicants shall be notified of their their school assignment through through an Application Receipt or a Notice of School Ass ignment ignment (NOSA). (NOSA ). They can also use the Online Notice of School Assignment A ssignment (ONSA) (ONS A) found in the CS CSC C Website (www.csc.gov.ph) (www.csc.gov.ph) to get a print-out print-out of their their NOS A. If applicants still do not know their school assignment assignment or cannot 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 F ailure to come on your scheduled sche duled examination will mean forfeiture of examination fee and slot.
B. FOR APPLICANTS OF CSE COMPUTER-ASSISTED TEST (CSE-CAT) (CSE-CAT) F ailure to come on your scheduled schedule d examination examination will mean forfeiture of examination fee and slot. IMPORTANT: All
personal belongings including cellular phones, phones, calculators, books, and all other electronic and printed printed materials materials must must be surrendered to the Room Ro om E xaminers. xaminers. Firearm Fi rearms, s, if any, any, must must also be surrendered to the security guard/designated guard/designated firearm custodian at the entrance entrance gate gate of the testing center. P roper attire should be worn on filing of application applica tion form and on examination day. (e.g. NOT IN SL EEVELESS SHIRT/BLOUSE, OR IN SHORT PANTS, OR IN SL IPPERS) BRING THE FOLLOWING ON EXAMINATION DAY
1. 2.
This Application Receipt or Notice of School Sc hool Assignm Ass ignment Same valid valid I.D. presented presented at the time time of filing of application application (NO I.D., NO EXAM )
3. 4.
One (1) blue or black ballpen Lead pencil/s No. 1 or 2 and eraser/s
