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    Uthman Bin Affan Foundation Academy Inc. Application Form

    Uploaded by

    Shaira MP
    This document is an application form for Uthman Bin Affan Foundation Academy Inc. It contains personal information about the applicant such as name, date of birth, addresses, contact details, family background, educational attainment, work experience, references, and a certification statement signed by the applicant pledging that all information provided is accurate. The applicant is Shaira Micah Pacas who is applying with the goal of employment at the academy.

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    Uthman Bin Affan Foundation Academy Inc. Application Form

    Uploaded by

    Shaira MP
    50 views5 pages
    This document is an application form for Uthman Bin Affan Foundation Academy Inc. It contains personal information about the applicant such as name, date of birth, addresses, contact details, family background, educational attainment, work experience, references, and a certification statement signed by the applicant pledging that all information provided is accurate. The applicant is Shaira Micah Pacas who is applying with the goal of employment at the academy.

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    This document is an application form for Uthman Bin Affan Foundation Academy Inc. It contains personal information about the applicant such as name, date of birth, addresses, contact details, family background, educational attainment, work experience, references, and a certification statement signed by the applicant pledging that all information provided is accurate. The applicant is Shaira Micah Pacas who is applying with the goal of employment at the academy.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    50 views5 pages

    Uthman Bin Affan Foundation Academy Inc. Application Form

    Uploaded by

    Shaira MP
    This document is an application form for Uthman Bin Affan Foundation Academy Inc. It contains personal information about the applicant such as name, date of birth, addresses, contact details, family background, educational attainment, work experience, references, and a certification statement signed by the applicant pledging that all information provided is accurate. The applicant is Shaira Micah Pacas who is applying with the goal of employment at the academy.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 5

    UTHMAN BIN AFFAN FOUNDATION ACADEMY INC.

    APPLICATION FORM

    Application No.: ____________


    I. PERSONAL INFORMATION

    PACAS SHAIRA MICAH BARTOCES


    Last name First name Middle name

    APRIL 1, 1996 OROQUIETA CITY FEMALE SINGLE


    Date of Birth Place of Birth Gender Civil Status

    2ND FLOOR, ESG BUILDING, LLUCH ST., POBLACION, ILIGAN CITY, LANAO DEL NORTE, 9200

    (Current Address) House no. Street Barangay City/ Municipal Province Zip code

    BLK. 4 LOT 13, PHASE 1, TRANSVILLE VILLAFLOR, OROQUIETA CITY, MISAMIS OCCIDENTAL, 7200

    (Permanent Address) House no./ street Barangay City/ Municipal Province Zip code

    FILIPINO ISLAM CEBUANO N/A


    Citizenship Religion Tribe Telephone No.

    09954686036, 09103113727 micahpacas@gmail.com


    Mobile No. Email Address (if any)

    II. FAMILY BACKGROUND


    N/A N/A N/A N/A
    Spouse’s Last Name First Name Middle Name Occupation

    PACAS ROGELIO JR. DUHAYLUNGSOD


    Father’s Last Name First Name Middle Name

    BARTOCES JINKIE BARORO


    Mother’s(Maiden) Last Name First Name Middle Name

    III. EDUCATIONAL BACKGROUND

    Period of
    Attendace
    Basic Year
    Education/Degree/Course Graduated
    Level Name of School
    From To

    Elementary ORQUIETA CITY NATIONAL SPECIAL SCIENCE 2003 2009 2009


    ELEMENTARY SCHOOL PROGRAM

    Secondary MISAMIS OCCIDENTAL SPECIAL SCIENCE 2009 2013 20013


    NATIONAL HIGH SCHOOL PROGRAM

    College MINDANAO STATE BACHELOR IN SECONDARY 2013 2017 2017


    UNIVERSITY - ILIGAN EDUCATION major in
    INSTITUTE OF TECHNOLOGY AND
    TECHNOLOGY LIVELIHOOD EDUCATION

    Graduate MINDANAO STATE LAW 2019 ONGOING N/A


    Studies UNIVERSITY - ILIGAN
    INSTITUTE OF
    TECHNOLOGY

    Others TESDA COOKERY (NCII) 2019 2019

    Government /Licensing Exam Passed

    LICENSURE FOR TEACHERS BOARD EXAMINATION


    Professional Certifications

    COOKERY NC II

    Membership in Professional Organizations, Associations, etc.

    RISALE-I NUR INSTITUTION (volunteer)

    GPA (Grade Point Average)

    2.05

    IV. SCHOLASTIC INFORMATION

    Academic achievements, honors, awards received in college/university

    N/A

    Have you ever been convicted of a felony?

    [ ] YES [*] NO

    V. WORK EXPERIENCE (Include private employment.)

    Department/ Agency/ Office/ Company Position Employment Period Monthly Salary

    (write in full)

    CUSTOMER 2017-2018 15,000


    SERVICE
    TELEPERFORMANCE REPRESENTATIVE

    APPLESEED MONTESSORI PRESCHOOL 2018 18,000


    PRESCHOOL TEACHER

    SILVER EDGE MEDIA SEO SPECIALIST 2019 15,000


    VI. REFERENCES (Person not related by consanguinity or affinity to applicant/appointee)

    Name Address Telephone. No.

    ILIGAN CITY, LANAO DEL NORTE 09480653822

    MA. JEANIFER TROCIO

    JELLA MAE GARCIA QUEZON CITY, METRO MANILA 09773694014

    OROQUIETA CITY, MISAMIS 09569329892


    OCCIDENTAL
    JINKIE B. PACAS

    VII. CERTIFICATION

    I hereby certify that I have read and fully understood all the instructions regarding my application for admission to
    Uthman Bin Affan Foundation Academy Inc. and that the informations stated in this application form are correct and
    complete. I understand that incomplete or inaccurate information could be prejudiced to my application. If accepted as an
    employee of UBAFAI, I agree to abide all its policies and regulations.

    11/20/2019
    APPLICANT’S SIGNATURE DATE

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