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NATIONAL SKILLS REGISTRATION PROGRAM
REGISTRATION FORM
INSTRUCTIONS:
Please fill out the form legibly. Print in block letters. Check appropriate boxes. Please do not leave any items unanswered. Indicate
"NA"
if not applicable.
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Email
*
Your email
I. PERSONAL INFORMATION
LAST NAME:
*
Your answer
FIRST NAME:
Your answer
MIDDLE NAME:
Your answer
SUFFIX (Sr., Jr.):
Your answer
DATE OF BIRTH:
MM
/
DD
/
YYYY
AGE:
Your answer
SEX:
MALE
FEMALE
Clear selection
PRESENT ADDRESS
HOUSE NO./ STREET VILLAGE:
Your answer
BARANGAY:
Your answer
MUNICIPALITY/CITY:
Your answer
PROVINCE:
Your answer
PLACE OF BIRTH:
Your answer
CIVIL STATUS:
SINGLE
WIDOWED
MARRIED
SEPARATED
Other:
Clear selection
CITIZENSHIP:
Your answer
HEIGHT:
Your answer
WEIGHT:
Your answer
LANDLINE NUMBER:
Your answer
MOBILE NUMBER (Primary, Secondary Number)
Your answer
EMAIL ADDRESS:
Your answer
DISABILITY:
VISUAL
HEARING
SPEECH
PHYSICAL
Other:
EMPLOYMENT STATUS:
EMPLOYED
WAGE EMPLOYED
SELF EMPLOYED
UNEMPLOYED
NEW ENTRANT/FRESH GRADUATE
FINISHED CONTRACT
RESIGNED
RETIRED
TERMINATED/LAIDOFF(local)
TERMINATED/LAIDOFF(abroad)
Other:
Are you actively looking for work?
Yes
No
Clear selection
If Yes, How long have you been looking for work?
Your answer
Willing to work immediately?
Yes
No
Clear selection
If No, when?
Your answer
Are you a 4Ps Beneficiary?
Yes
No
Clear selection
If Yes, Household ID No.
Your answer
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