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    Spes Form 2

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    hrstaff1144
    This document is an application form for the Special Program for Employment of Students (SPES) from the Department of Labor and Employment in the Philippines. It collects personal information from applicants such as name, date of birth, contact details, education history, and parental income/occupation. Applicants must be 15-30 years old and submit documents verifying their age, income status, and student/education status. By signing, applicants agree that any false statements would result in disqualification and penalties.

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    © All Rights Reserved
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    Spes Form 2

    Uploaded by

    hrstaff1144
    175 views1 page
    This document is an application form for the Special Program for Employment of Students (SPES) from the Department of Labor and Employment in the Philippines. It collects personal information from applicants such as name, date of birth, contact details, education history, and parental income/occupation. Applicants must be 15-30 years old and submit documents verifying their age, income status, and student/education status. By signing, applicants agree that any false statements would result in disqualification and penalties.

    Original Title

    SPES-FORM-2

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    This document is an application form for the Special Program for Employment of Students (SPES) from the Department of Labor and Employment in the Philippines. It collects personal information from applicants such as name, date of birth, contact details, education history, and parental income/occupation. Applicants must be 15-30 years old and submit documents verifying their age, income status, and student/education status. By signing, applicants agree that any false statements would result in disqualification and penalties.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    175 views1 page

    Spes Form 2

    Uploaded by

    hrstaff1144
    This document is an application form for the Special Program for Employment of Students (SPES) from the Department of Labor and Employment in the Philippines. It collects personal information from applicants such as name, date of birth, contact details, education history, and parental income/occupation. Applicants must be 15-30 years old and submit documents verifying their age, income status, and student/education status. By signing, applicants agree that any false statements would result in disqualification and penalties.

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    © All Rights Reserved
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    SPES Form 2

    REPUBLIC OF THE PHILIPPINES


    DEPARTMENT OF LABOR AND EMPLOYMENT
    Regional Office No. IV-A (CALABARZON)
    PUBLIC EMPLOYMENT SERVICE OFFICE
    PROVINCE OF LAGUNA
    SPECIAL PROGRAM FOR EMPLOYMENT OF STUDENTS
    (RA 7323, as amended by RAs 9547 and 10917)

    APPLICATION Control No.:


    FORM
    By accomplishing this form, you signify your acceptance to provide pertinent and personal information about you. In compliance with Republic Act
    10173 otherwise known as the Data Privacy Act of 2013, all information that will be collected through this form will be used for the sole purpose
    of fulfilling the functions of this Office.
    SURNAME FIRST NAME MIDDLE NAME GSIS BENEFICIARY/RELATIONSHIP
    H. TAHER JONNAIRE BANTUAS ROHAINA HADJETAHER/MOTHER
    DATE OF BIRTH:(mm/dd/yyyy) PLACE OF BIRTH: CITIZENSHIP:
    06/01/2000 BIÑAN CITY, LAGUNA FILIPINO
    Passport Size
    CONTACT DETAILS/CELLPHONE NO.: EMAIL ADDRESS: Picture (3.5cm x
    09120071206 jbh.taher@gmail.com 4.5 cm)
    SOCIAL MEDIA ACCOUNT (FACEBOOK, TWITTER, INSTAGRAM, ETC.)
    @Jonnaire Taher, @jnr.taherrr
    STATUS SEX  Student  ALS student
     Single  Married  Widow/er  Separated  Male  Female  out-of-school (OSY)
    CURRENT STATUS OF THE BENEFICIARY/PARENTS:  Living together  Solo Parent  Separated  Senior Citizen
     Sugar Plantation Worker  Indigenous People  Displaced Worker (1)  Local (2)  OFW
     Rebel Returnee  Victims of Armed Conflicts  Person with Disability
    PRESENT ADDRESS:
    BRGY. DELA PAZ, BIÑAN CITY, LAGUNA
    PERMANENT ADDRESS:
    BRGY. DELA PAZ, BIÑAN CITY, LAGUNA
    FATHER’S NAME /CONTACT NO.: MOTHER’S MAIDEN NAME/CONTACT NO.:
    ALICAN T. HADJETAHER ROHAINA I. BANTUAS/09854009051
    OCCUPATION: OCCUPATION:
    VENDOR VENDOR
    EDUCATION NAME OF SCHOOL DEGREE EARNED/COURSE YEAR/LEVEL DATE OF ATTENDANCE
    Elementary DR. MARCELINO Z. BATISTA ELEM. SC. VENDOR
    Secondary
    Tertiary
    Tech-Voc
    DOCUMENTARY REQUIREMENTS:
    (Original and other documents, when applicable, should be presented for validation)
    [ ] 1) Photocopy of Birth Certificate or any document indicating date of birth or age (age must be 15-30)
    [ ] 2) Photocopy of the latest Income Tax Return (ITR) of parents/legal guardian OR certification issued by BIR that the
    Parents/guardians are exempted from payment of tax OR original Certificate of Indigence OR original Certificate
    of Low Income issued by the Barangay or DSWD/CSWD where the applicant resides; and
    [ ] 3) For students, any of the following, in addition to requirements no. 1 and 2:
    [ ] a) Photocopy of proof of average passing grade such as (1) class card or (2) Form 138 of the previous semester
    or year immediately preceding the application; OR
    [ ] b) Original copy of Certification by the School Registrar as to passing grade immediately preceding
    semester/year if grades are not yet available
    [ ] 4) For Out of School Youth (OSY), original copy of Certification as OSY issued by DSWD/CSWD or the authorized
    Barangay Official where the OSY resides, in addition to requirements no. 1 and 2.
    SPECIAL SKILLS:

    HISTORY of SPES Availment/ Name of Establishment YEAR SPES ID NO. (if applicable)
    st
    [ ] 1 Availment
    [ ] 2ndAvailment
    [ ] 3rdAvailment
    [ ] 4thAvailment
    Other related information/ requests/ interventions from DOLE:

    I hereby attest that the information above is true and correct to the best of my knowledge, including the attached documents / requirements
    which I also attest as to their veracity. I agree that any false statement would cause the automatic disqualification/ cancellation of the service/
    contract/ grant and I shall refund amount received and/or pay damages to DOLE or comply with other sanctions in accordance with law. Any
    material change in my financial status may affect my eligibility to continue the program.

    Signature of Applicant

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