ALL INFORMATION PROVIDED WILL BE TREATED WITH UTMOST CONFIDENTIALITY.

Photo taken not

BJMP APPLICANTS PERSONAL more than 6
months ago 3.5
PROFILE FORM cm x 4.5 cm
(passport size)

DI FORM NO. 1 S. 2022

INSTRUCTIONS (Print legibly. Mark appropriate boxes with [x])
1 Answer all questions completely. If question is not applicable, write “NA”. Write “UNKNOWN” if you do not know the
answer and cannot obtain the answer from personal records.

2 Print or write carefully in ballpen or fountain pen. Illegible or incomplete forms will have to be done over. Use additional sheets
for extra details for any question/s for which you do not have sufficient space.

3 The correctness of all statements made here will be verified. Any deliberate omission or distortion of material facts may give
sufficient cause for disapproval of application.

4 Be as complete, honest, and specific as possible in your responses.

I. PERSONAL INFORMATION
1 SURNAME 10 NAME EXTENSION
FIRST NAME 11 SEX
MIDDLE NAME 12 CIVIL STATUS
2 DATE OF BIRTH 13 RELIGION
3 PLACE OF BIRTH 14 TRIBE/ETHNICITY
4 CITIZENSHIP 15 BLOOD TYPE
5 HEIGHT (cm) 16 BUILT
6 WEIGHT (kg) 17 COMPLEXION
7 PRESENT
ADDRESS
(Specify exact
location of address
including the
Barangay)
8 PERMANENT
ADDRESS
(Specify exact
location of address
including the
Barangay)

9 EMAIL ADDRESS 18 MOBILE PHONE NO.

II. SOCIAL MEDIA ACCOUNTS (ACCOUNT NAME)

19 Facebook Tiktok
Instagram LinkedIn
Twitter Others
III. DISTINGUISHING MARKS (ex. Birth marks, eartags, excess skin, tattoo, etc.)
LOCATION
LOCATION
LOCATION
LOCATION

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ALL INFORMATION PROVIDED WILL BE TREATED WITH UTMOST CONFIDENTIALITY.
IV FAMILY BACKGROUND
20 SPOUSE/ LIVE-IN PARTNER/ FIANCÉ/E
[ ] Spouse [ ] Others: DATE OF BIRTH
SURNAME MOBILE NO.
FIRST NAME OCCUPATION
MIDDLE EMPLOYER

NAME
ADDRESS EMPLOYER'S
ADDRESS

21 CHILDREN OR DEPENDENTS
List all of your children, including natural, adopted, step, and/or foster care.
NAME DATE OF BIRTH AGE

(Continue on separate sheet, if necessary)

22 PARENTS
NAME OF FATHER NAME OF MOTHER

OCCUPATION OCCUPATION
PARENT'S ADDRESS

23 IN-LAWS
NAME OF FATHER-IN-LAW NAME OF MOTHER-IN-LAW

OCCUPATION OCCUPATION

PARENTS-IN-LAWS
ADDRESS

24 BROTHERS AND SISTERS

NAME DATE OF BIRTH CIVIL STATUS OCCUPATION ADDRESS

(Continue on separate sheet, if necessary)

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ALL INFORMATION PROVIDED WILL BE TREATED WITH UTMOST CONFIDENTIALITY.
25 RELATIVES IN THE BJMP OR OTHER GOVERNMENT AGENCY
NAME RELATIONSHIP POSITION OFFICE AND ADDRESS

(Continue on separate sheet, if necessary)

26 RECOMMENDED BY AND/OR CONTACT PERSON IN THE BJMP
RANK/NAME UNIT DESIGNATION

27 RELATIVE/S DETAINED IN BJMP JAILS

NAME RELATIONSHIP JAIL DETAINED

(Continue on separate sheet, if necessary)

V EDUCATIONAL BACKGROUND
NAME OF SCHOOL AND HIGHEST LEVEL/ INCLUSIVE DATES ACADEMIC
DEGREE/
28 LEVEL ADDRESS UNITS EARNED IF HONORS
(WRITE IN FULL) COURSE NOT GRADUATED FROM TO RECEIVED

ELEMENTARY

JUNIOR HIGH
SCHOOL

SENIOR HIGH
SCHOOL

VOCATIONAL
COURSE

TERTIARY

POST
GRADUATE

VI EMPLOYMENT HISTORY
Chronological History of Employment since 18th birthday. Account for all periods. Include all work experiences, regardless of nature and
period, both local and foreign.

29 INCLUSIVE DATES EMPLOYER CAUSE OF

POSITION HELD EMPLOYER'S ADDRESS
FROM TO (WRITE IN FULL) SEPARATION

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ALL INFORMATION PROVIDED WILL BE TREATED WITH UTMOST CONFIDENTIALITY.
30 IF SELF-EMPLOYED
NATURE OF BUSINESS/SOURCE OF INCOME DATE ESTABLISHED

VII CLUBS, SOCIETIES AND OTHER ORGANIZATIONS

List names and addresses of all clubs, societies, employees groups, organizations, homeowners associations whether elected or appointed including NGO
membership of any kind (or membership/support in any organization having headquarters or branch in a foreign country) to which you belong or have
belonged.
PERIOD OF
31 NAME MEMBERSHIP POSITION HELD ADDRESS
FROM TO

(Continue on separate sheet, if necessary)

VIII CHARACTER REFERENCES
List of at least 5 people who know you well, such as social and family friends, co-workers, government acquaintances. Do not include
relatives, employers or housemates, or other individuals listed in this document.

32 NAME COMPLETE HOME AND BUSINESS ADDRESS CONTACT DETAILS

List of at least 3 people who are your neighbors in your present residence.

33 NAME COMPLETE HOME AND BUSINESS ADDRESS CONTACT DETAILS

IX OTHER QUALITIES AND INFORMATION

LANGUAGE/S AND DEGREE OF
34 PROFICIENCY

35 SPECIAL SKILLS

36 HOBBIES

37 SPORTS

38 AWARDS AND RECOGNITION

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ALL INFORMATION PROVIDED WILL BE TREATED WITH UTMOST CONFIDENTIALITY.
X ELIGIBILITY
39 ELIGIBILIT RATING PLACE TAKEN EXPIRY DATE
Y

XI WAIVER
40 ISSUING AGENCY TRIBAL MEMBERSHIP CONTROL NO. TYPE OF WAIVER

XII FINANCIAL BACKGROUND

41 NAME OF BANKS/LENDING INSTITUTION/S WHICH YOU HAVE AN EXISTING LOAN
NAME OF INSTITUTION BRANCH YEAR OF MEMBERSHIP

42 HAVE YOU FILED A STATEMENT OF ASSETS, LIABILITIES, AND NETWORTH?

[ ] YES [ ] NO
IF SO, IN WHAT AGENCY?
43 HAVE YOU FILED YOUR INCOME TAX RETURN?
[ ] YES [ ] NO
XIII PLACES OF RESIDENCE/S
44 INCLUSIVE DATES COMPLETE ADDRESS
FROM TO (To include house no., street name, purok/zone, barangay, city/municipality)

XIV MISCELLANEOUS INFORMATION

IF YES, GIVE THE DETAILS.
QUESTIONS YES NO (Attach supporting documents)
45 HAVE YOU EVER BEEN ARRESTED FOR ANY
VIOLATION OF LAW OTHER THAN TRAFFIC [ ] [ ]
VIOLATION?

46 HAVE YOU EVER BEEN CHARGED WITH ANY CRIME

OR VIOLATION OF ANY LAW, DECREE, ORDINANCE
OR REGULATIONS IN ANY COURT OR TRIBUNAL?
[ ] [ ]

47 HAVE YOU EVER BEEN CONVICTED OF ANY CRIME OR

VIOLATION OF ANY LAW, DECREE, ORDINANCE
OR REGULATIONS IN ANY COURT OR TRIBUNAL?
[ ] [ ]

48 HAVE YOU EVER BEEN CHARGED WITH ANY

ADMINISTRATIVE OFFENSE? [ ] [ ]

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ALL INFORMATION PROVIDED WILL BE TREATED WITH UTMOST CONFIDENTIALITY.
IF YES, GIVE THE DETAILS.
QUESTIONS YES NO
(Attach supporting documents)
49 HAVE YOU EVER BEEN DECLARED GUILTY OF ANY
ADMINISTRATIVE OFFENSE? [ ] [ ]

50 HAVE YOU EVER BEEN FORCED TO RESIGN OR BE

DROPPED FROM EMPLOYMENT IN THE PUBLIC OR [ ] [ ]
PRIVATE SECTOR?
QUESTIONS YES NO IF YES, UP TO WHAT EXTENT?
51 DO YOU DRINK INTOXICANT/S? [ ] [ ]
52 DO YOU TAKE PROHIBITED DRUGS OR ANY ILLEGAL
SUBSTANCE?
[ ] [ ]
XV SKETCH MAP/S
(If needed, you may use additional sheet/s of paper or another page. If possible, indicate at least two (2) prominent landmarks going to
and from the exact location /address.)
53 PRESENT ADDRESS

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ALL INFORMATION PROVIDED WILL BE TREATED WITH UTMOST CONFIDENTIALITY.
54 PERMANENT ADDRESS
(If needed, you may use additional sheet of paper or another page. If possible, indicate at least two (2) prominent landmarks going to and from the
exact location /address.)

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ALL INFORMATION PROVIDED WILL BE TREATED WITH UTMOST CONFIDENTIALITY.
55 WHOLE BODY PICTURE
Attach 4R size recently taken whole body picture.

Security Measures for Your Data: Retention of Your Information:

1. To protect your personal information, we are implementing 1. The authorized personnel retain the application
administrative, physical, and technical security measures. records of non-successful candidates for a period of
2. Your personal information is only accessible to authorized six (6) months.
BJMP personnel. 2. We take reasonable steps to securely delete your
3. Both your paper and digital files are safely stored; the personal data when it is no longer required. Electronic
paper files are protected with physical protection, while the digital data is also deleted, and to ensure that it cannot be
files are secured with technical security. recovered or replicated. Paper files are securely
shredded.
Your Right as Data Subject:
You have the right to object processing, request access to, and correction of your personnal data, as well as withdrawal
or deletion of your personal data.

Consent to Collect Personal and Sensitive Information:

My signature below affirms that I have read this form, understood its contents, consent to the collection of my personal and
sensitive data; primarily, for the conduct of background investigation for my application for the vacant position. I understand that
my withdrawal of or refusal to process my personal data may result to the denial of my application for employment with the
BJMP.

Printed Name and Signature Date

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