Republic of the Philippines

Department of Labor and Employment

NATIONAL SKILLS REGISTRATION PROGRAM

NSRP Form 1
October 2014

1x1
ID Photo
(optional)

REGISTRATION FORM

Form Control No.:

INSTRUCTIONS: Please fill out the form legibly with ballpen. Print in block letters. Check appropriate
boxes. Please do not leave any items unanswered. Indicate "NA" if not applicable. You may use extra
sheets if needed. Submit accomplished form to the Public Employment Service Office Manager or
Officer in your city/municipality.
*optional
I. PERSONAL INFORMATION
SURNAME
DATE OF BIRTH (mm/dd/yyyy)
SEX

c Male

AGE
c Female

PRESENT ADDRESS
House No./Street/Village

PLACE OF BIRTH
c Single
CIVIL STATUS

MIDDLE NAME

FIRST NAME

c Married

Barangay

c Widowed c Seperated

Municipality/City

c Others, specify: _________________

Province
PERMANENT ADDRESS

CITIZENSHIP
HEIGHT

House No./Street/Village

WEIGHT

RELIGION*

Barangay

TIN*
GSIS/SSS ID NO.*

Municipality/City
Province

PAG-IBIG NO.*

LANDLINE NUMBER

PHILHEALTH NO.*

CELLPHONE NUMBER

EMAIL ADDRESS
DISABILITY

c Visual

c Speech

c Hearing

c Physical

c Employed
EMPLOYMENT
STATUS

c Others, specify:
______________________________
c Unemployed

c Wage Employed

c New Entrant/Fresh Graduate

c Retired

c Self Employed

c Finished Contract

c Terminated/Laid off (local)

c Resigned

c Terminated/Laid off (abroad)

c Others, specify: ____________

Are you actively looking for work?
Willing to work immediately?

c Yes

c No

Specify country: ____________

How long have you been looking for work? _________

c Yes c No If no, when? _____________________________

II. JOB PREFERENCES

OCCUPATION
PREFERRED
OCCUPATION AND
INDUSTRY

INDUSTRY

1.
2.
3.
c Local, specify cities/municipalities:

c Overseas, specify countries:

PREFERRED WORK 1. ____________________________

LOCATION
2. ____________________________

1. ________________________

3. ____________________________

3. _______________________

2. ________________________

III. LANGUAGE PROFICIENCY

LANGUAGE (Yes/No)
English
Filipino
Others: __________________

READ

WRITE

SPEAK

UNDERSTAND

With passport?
c Yes

c No

Expiry date (mm/dd/yyyy)

IV. EDUCATIONAL BACKGROUND

Currently in school?

c Yes

c No

c No formal education
c Incomplete high school level c College graduate
HIGHEST
c Incomplete elementary level c High school graduate
c Technical-vocational graduate
EDUCATIONAL LEVEL
c Incomplete college level
c Post graduate
c Elementary graduate
YEAR GRADUATED/LAST ATTENDED (yyyy)
SCHOOL/UNIVERSITY
COURSE/PROGRAM
AWARDS/HONORS RECEIVED
V. TECHNICAL/VOCATIONAL AND OTHER TRAINING (Include courses taken as part of college education)
Currently in training?

c Yes

TRAINING

c No
DURATION OF COURSE
(mm/dd/yyyy to mm/dd/yyyy)

TRAINING
INSTITUTION

CERTIFICATES
RECEIVED

COMPLETED
c Yes c No
c Yes c No
c Yes c No
c Yes c No

VI. ELIGIBILITY/LICENSE
CAREER SERVICE/BOARD/BAR

LICENSE NUMBER

EXPIRY DATE

VII. WORK EXPERIENCE (Limit to 10 years experience, start with the most recent employment)
INCLUSIVE
NAME OF
ADDRESS
POSITION HELD
DATES
OFFICE/COMPANY
(mm/yyyy to mm/yyyy)

STATUS OF
APPOINTMENT*

*Status of appointment can be either of the ff.: Permanent, Contractual, Part-time, Probationary, etc.

VIII. OTHER SKILLS ACQUIRED WITHOUT FORMAL TRAINING

CERTIFICATION/AUTHORIZATION
This is to certify that all data/information that I have provided in this form are true to the best of my knowledge. This is also to authorize the DOLE to
include my profile in the Skills Registry System, which is maintained in the Enhanced Phil-JobNet. It is understood that my name shall be made
available to employers who may have access to the Registry. 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.
Eligible for public employment services?
Assesed by:
c SPES
c GIP
__________________________________________
_____________
Signiture
Over
Printed
Name
of
Assessor
c TUPAD
Date
c JobStart
c Others, specify: ____________________