NSRP form 1 Republic of the Philippines

September Department of Labor and Employment

2020 NATIONAL SKILSS REGISTRATION PROGRAM JOBSEEKER
REGISTRATION FORM
INSTRUCTIONS: Please fill out the form legibly in block letters using a ballpoint pen. Check appropriate boxes. Please do not leave any
items unanswered. Indicate “NA” if not applicable. You may use extra sheet if needed. Submit accomplished form to the Public
Employment Service Office (PESO) Manager or Officer in your city/municipality.
I. PERSONAL INFORMATION

----------------------------- ------------------------------------ ------------------------------------------- ----------------------------

SURNAME FIRST NAME MIDDLE NAME SUFFIX (Ex. Sr., Jr., etc.)
DATE OF BIRTH (mm/dd/yyyy) _________________________________
SEX _____ MALE ______ FEMALE PRESENT ADRESS
RELIGION House No./ Street
Village
CIVIL STATUS Barangay
______ Single Municipality City
______ Married
______ Widowed Province
TIN NO. ___________________________ HEIGHT (FT.)
DISABILITY ____Visual ___Speech ____Mental CONTACT
___Hearing __Physical __ others Please specify: ________ NUMBER/S
E-MAIL
EMPLOYMENT STATUS/TYPE
____ Employed ____ Unemployed
___Wage employed How long have you been looking for work?
___Self-employed (pls. specify) (months) ________

_____ Fisherman/Fisherfolk ______New Entrant/Fresh Graduate

_____Vendor/Retailer ______Finished Contract
_____Home-based worker ______Resigned
_____ Transport ______Retired
____Domestic Worker ______Terminated/Laid off due to calamity
_____ Freelancer ______Terminated/Laid Off(abroad)
_____Artisan/Craft Worker Specify country: ___________________
______Others (pls. specify): ______ others, please specify:
__________________
Are you an OFW? ___Yes ____No Are you a former OFW? _____Yes _____No
Specify country: ____________________ Latest country deployment: ___________________
Month and year Return to Philippines? _____________________

Are you a 4Ps beneficiary? ____Yes ____No if yes, please provide Household ID No. __________________________

II. JOB PREFERENCE

PREFERRED OCCUPATION PREFERRED WORK LOCATION
_____ Part-Time ______ Full-Time ____ Local _______ Overseas, (specify countries)
(specify
cities/municipal
ities
1. 1. 1
2. 2. 2.
3. 3. 3.

III. LANGUAGE/DIALECT PROFICIENCY (check if applicable)

LANGUAGE/DIALECT READ WRITE SPEAK UNDERSTAND
English
Filipino
Mandarin
Others: _________

IV. EDUCATIONAL BACKGROUND

Currently in school? ___ Yes _____No
LEVEL SCHOOL/COURSE YEAR IF UNDERGRADUATE
GRADUATED LEVEL REACHED YEAR LAST ATTENDED
Elementary

Secondary

Senior High School

Tertiary

Graduate
Studies/PostGraduate
V. TECHNICAL/VOCATIONAL AND OTHER TRAINING (Include courses taken as part of college education)
TRAINING/VOCATIONAL HOURS OF TRAINING TRAINING SKILLS CERTIFICATES RECEIVED
COURSE INSTITUTION ACQUIRED (NC I, NC II, NC III, NC IV,
etc.)
1.
2.
3.
VI. ELIGIBILITY/ PROFESSIONAL LICENSE
CAREER SERVICE/BOARD/BAR LICENSE NUMBER DATE TAKEN VALID UNTIL
1.
2.
VII. WORK EXPERIENCE (Limit to 10 year period, start with the most recent employment)
COMPANY NAME ADDRESS POSITION NUMBER OF STATUS
(City/Municipality) MONTHS (Permanent, Contractual,
Part-time, Probationary)

VIII. OTHER SKILLS ACQUIRED WITHOUT CERTIFICATE

____ AUTO MECHANIC _______ ELECTRICIAN ______ PHOTGRAPHY

____ BEAUTICIAN _______EMBROIDERY ______PLUMBING
____ CARPENTRY WORK _______ GARDENING ______ SEWING DRESSES
____ COMPUTER LITERATE ______ MASONERY ______ STENOGRAPHY
____ DOMESTIC HORES ______ PAINTER/ARTIST ______ TAILORING
____ DRIVER ______ PAINTING JOBS ______OTHERS: ___________

CERTIFICATION/AUTHORIZATION

This is to certify that all the data/information that I have provided in this form are true to the best knowledge. This is also to
authorize DOLE to include my profile in PESO Employment Information System and use my personal information for employment
facilitation. I am also aware that DOLE is not obliged to seek employment on my behalf.

__________________________ ___________________
Signature of Applicant Date
FOR USE OF PESO ONLY, PLEASE DO NOT WRITE BELOW THIS DOTTED LINE.
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Referred to: Assessed by:

___ SPES _____ DILEEP
___ GIP _____ TESDA Training
___ TUPAD ______________________________ _____________
___ Jobstart Signature over Printed Name of Assessor Date __ Others,
specify: _________