20%

PAALALA

Isang Beses lamang magregister. Siguraduhin na TAMA ang mga impormasyon at tiyakin na KUMPLETO ito bago pindutin ang SUBMIT button upang maiwasan ang pagdoble ng iyong record.

Pahintulot sa pribadong impormasyon

Sa pamamagitan nito, ako'y nagpapahayag ng aking pahintulot para sa Lungsod ng Caloocan sa pamamagitan ng Tanggapan ng "Persons with Disability Affairs Office" upang kolektahin at iproseso ang aking personal na impormasyon para sa layunin ng pag proseso ng PVC Identification Card. Ang impormasyon na ito ay ituturing na kumpidensyal ayon sa batas ukol sa Data Privacy ng 2012

Pindutin kung pinahihintulutan

PERSONAL NA IMPORMASYON

Paki kumpletuhin ang mga hinihinging detalye sa form!

First Name *

Last Name *

Suffix

Meron ka bang Middle Name? *

MERON

WALA

Educational Attainment

Sex *

Blood Type

Civil Status *

Date of Birth *

Edad

Complete Address *

Barangay *

Valid ID *

Apparently Disabled? *

(Ang apparent disability ay kapansanang madaling makita)

Type of Disability *

Cause of Disability *

Status of Employment *

Category of Employment *

Types of Employment *

Occupation *

Landline Number

Cellphone Number *

Email Address

EMERGENCY CONTACT PERSON

in case of emergency!

Full Name *

Contact Number *

Complete Address *

Personal na litrato

Pindutin dito para i-on ang camera

PAALALA:

Siguraduhing pasok ang mukha sa bilog at gumamit ng malinis na PLAIN WHITE BACKGOUND sa pagkakuha ng personal na Litrato. Magsuot ng maayos na damit ( Polo shirt, T-shirt, Blouse )

Gagamitin ang litrato sa PDAO ID

Valid ID

Pindutin dito para i-on ang camera

PAALALA:

Siguraduhing pasok sa camera at malinaw ang pagkaka-kuha ng iyong VALID ID.

Whole Body

Pindutin dito para i-on ang camera

PAALALA:

Siguraduhing pasok sa camera at malinaw ang pagkaka-kuha ng iyong WHOLE BODY PICTURE.

Personal na impormasyon

First Name

Middle Name

Last Name

Suffix

Sex

Blood Type

Educational Attainment

Civil Status

Birthday

Age

Home Address

Barangay

Chosen Valid ID

Apparently Disabled?

Type of Disability

Cause of Disability

Specification (Congenital / Inborn)

Other - Specify Disability (Congenital / Inborn)

Specification (Acquired)

Other - Specify Disability (Acquired)

Employment Status

Employment Category

Employment Type

Occupation

Other Occupation

Cellphone Number

In case of emergency!

Full Name

Cellphone Number

Address

Pictures taken!

Personal Picture

PAALALA

Pahintulot sa pribadong impormasyon

PERSONAL NA IMPORMASYON

First Name *

Last Name *

Suffix

Meron ka bang Middle Name? *

Middle Name *

Educational Attainment

Sex *

Blood Type

Civil Status *

Date of Birth *

Edad

Complete Address *

Barangay *

Valid ID *

Apparently Disabled? *

Type of Disability *

Cause of Disability *

Specification *

Specify Disability Congenital *

Specification (Acquired) *

Specify Disability Acquired *

Status of Employment *

Category of Employment *

Types of Employment *

Occupation *

Other Occupation *

Landline Number

Cellphone Number *

Email Address

EMERGENCY CONTACT PERSON

Full Name *

Contact Number *

Complete Address *

Personal na litrato

PAALALA:

Valid ID

PAALALA:

Whole Body

PAALALA:

Apparent Disability

PAALALA:

Medical Certificate

PAALALA:

Barangay Certificate

PAALALA:

Personal na impormasyon

First Name

Middle Name

Last Name

Suffix

Sex

Blood Type

Educational Attainment

Civil Status

Birthday

Age

Home Address

Barangay

Chosen Valid ID

Apparently Disabled?

Type of Disability

Cause of Disability

Specification (Congenital / Inborn)

Other - Specify Disability (Congenital / Inborn)

Specification (Acquired)

Other - Specify Disability (Acquired)

Employment Status

Employment Category

Employment Type

Occupation

Other Occupation

Cellphone Number

Landline Number

Email Address

Full Name

Cellphone Number

Address