SPES APPLICATION FORM
(Special Program for Employment of Students)
PERSONAL INFORMATION
Full Name: _______________________________________
Gender: _______________
Date of Birth: _______________
Age: ____________
Place of Birth: __________________________
Civil Status: _______________
Height: ____________
Weight: ____________
Citizenship: ___________________
Religion: ___________________
CONTACT DETAILS
Current Address: ______________________________________
Permanent Address: ____________________________________
Telephone No.: ________________
Cellphone No.: ________________
Email Address: ______________________________________
FAMILY BACKGROUND
Father’s Name: ____________________ | Occupation: ____________________
Mother’s Name: ____________________ | Occupation: ____________________
Annual Family Income: ________________
Number of Family Members: ____________
EDUCATIONAL BACKGROUND
School Name: ______________________________________
Level (Check one):
[ ] Senior High School [ ] College
Grade/Year Level: ___________________
Course/Strand (if applicable): ____________________________
School Address: ______________________________________
Year of Expected Graduation: __________________
SPES DETAILS
Have you applied for SPES before? [ ] Yes [ ] No
SPES ID Number (if applicable): _____________________
Preferred LGU/Office Assignment: ______________________
Language/Dialect Spoken: ______________________
EMERGENCY CONTACT
Name: ______________________________________
Relationship: __________________
Address: ______________________________________
Contact No.: __________________
CERTIFICATION
I hereby certify that the above information is true and correct to the best of my knowledge
and belief. I understand that any misrepresentation shall be grounds for disqualification or
withdrawal of benefits from the SPES program.
Date: _______________ Signature: ___________________________