Technical Education and Skills Development Authority

Pangasiwaan sa Edukasyong Teknikal at Pagpapaunlad ng Kasanayan

NMIS FORM –01A
( For TPIS and CACS )
TRAINOR’S/ASSESSOR’S PROFILE

ID PICTURE
(2”x 2” size)

Applicant’s Signature

1. To be accomplished by TESDA
1.1. NMIS Manpower Code: - 1.2. NMIS Entry Date:

2. Manpower Profile
2.1. Name: LIM JENSEN RYAN TAN
Last First Middle
Mailing 1278 QUEZON BACLARAN FOURTH
2.2. Address:
Number, Street Barangay District
CALAUAG QUEZON IVA-CALABARZON 4318 
City Province Region Zip Code P.O. Box No.
2.3. Sex 2.4. Civil Status 2.5. Contact Number(s) 2.6. Employment Type 2.7. Employment Status
 Male


Single Tel: (042) 717-7105 

Employed

Casual  Probationary

 Female Married Cellular: 0909 5150803 Self-employed Contractual  Regular

Window/er e-mail : jrtlim@[Link] Unemployed Job Order  Permanent

Separated Fax: Other than above Temporary
Others: Pls. specify If Student
 Trainee/OJT

3. Personal Information
3.1. Birthdate: SEPTEMBER 18, 1982 3.6. Weight: 54 KG 3.11. Distinguishing Marks:_____________
3.2. Birth Place: CALAUAG, QUEZON 3.7. Blood Type: O ______________________________
3.3. Citizenship: FILIPINO 3.8. SSS No.: 33-8556080-6
3.4. Religion: ROMAN CATHOLIC 3.9. GSIS No.: 2-005063-644
3.5. Height: 5’9” 3.10. TIN No: 300-051-174
4. Educational Background
4.1. 4.2. 4.3. 4.4. 4.5. 4.6. 4.7 4.8.
Educational Units Honors
School Level School Year Degree Minor Major Earned Received
CALAUAG EAST CENTRAL
ELEMENTARY SCHOOL ELEMENTARY 1989 1995 VALEDICTORIAN

ST PETER’S SCHOOL SECONDARY 1995 1999 VALEDICTORIAN

ACAD EXCELLENCE
CENTRO ESCOLAR UNIVERSITY TERTIARY 1999 2003 BS COMSCI AWAEDEE
POLYTECHNIC UNIVERSITY OF THE MASTER IN EDUC
PHILIPPINES POST GRAD 2015 2017 MANAGEMENT

5. Course Title (for TPIS, CACs) 5.2. Schedule /Duration 5.3. Aptitude Exam
5.1.
*Training Duration (No. of Hrs.)
Date:
*From:
*To: Time:
For Competency Assessment and Certification Applicants Only, fill-up this part.
6. Competency Assessment to Take (to be filled-up by TESDA Representative)
6.1. Date of Application: / / 6.7. Training Program 6.8. Program Sector 6.9. Client Type
(mm) (dd) (year) TESDA Grad.
6.2. Sector Component:  Formal  Public  Person with Disability
6.3. Trade Area:  Non-Formal  Industry  SCEP
6.4. Occupation:  Informal (prior learning)  OFW  Non-TESDA Grad.
6.5. Classification:    Other;  OFW
6.6. Competency:  Farmers; Fisherfolks
OSY
Others, pls. specify
Part II: The following entries can be skipped if you have previously filled up this form, except for some information that you would want to update.

7. WORKING EXPERIENCE ( For Trainers, mandatory field 7.5)

7.1. 7.2. 7.3. 7.4. 7.5. 7.6.
Occupation Type No. of Yrs.
Monthly Status of
Name of Company Position Inclusive Dates (Teaching; Non-Teaching; Working
Salary Appointment
Industrial Experience) Exp.
INFONxx Phils, Inc. CSR/TS 2003 2005 35,000.00 INDUSTIRAL EXPERIENCE REGULAR 2
RNC Technical Learning Center, Inc. TRAINOR 2005 2009 10,000.00 TEACHING/INDUSTRIAL EXP REGULAR 4
Calauag Montessori TRAINOR 2009 2016 10,000.00 TEACHING EXPERIENCE REGULAR 7
Lopez National Comprehensive TEACHING EXPERIENCE/
High School SHS T-II 2016 PRESENT 21,896.00 INDUSTRY EXPERIENCE PERMANENT 2
COIZ INTERNET SHOP TECHNICIAN 2015 PRESENT INDSUTRY EXPERIENCE FREELANCE 3
(For more information, indicate on a separate sheet)
8. Other Training/Seminars Attended
8.1. 8.2. 8.3. 8.4. 8.5. 8.6. 8.7. 8.8. 8.9.
Inclusive *Certificate # of Training
Title Venue Category Conducted By Proficiency
Dates Received Hours Base
8/14/ 9/22/
TMC MANILA 2017 2017 T 264 L M MISA I

(For more information, indicate on a separate sheet)

* Certificate Received Training Base Category Proficiency
A Certificate of Attendance S Skills Training Certificate L Local T Trade Skills Upgrading Program B Beginner
c Certificate of Competencies T Training Certificate F Foreign N Non-Trade Upgrading Program I Intermediate
P Certificate of Proficiency M Training Management A Advanced

9. Licenses/Examinations Passed
9.1. 9.2. 9.3. 9.4. 9.5. 9.6.
Title Year Taken Examination Venue Rating Remarks Expiry Date
Civil Service Sub Pro 2000 Quezon City 85.90 Passed None
Civil Service Pro 2003 Quezon City 90.07 Passed None
Board Licensure Examination
for Teachers 2014 Lucena City 81.04 Passed 9/18/2018
(For more information, indicate on a separate sheet)

10. Competency Assessment Passed

10.1. 10.2. 10.3. 10.4. 10.5. 10.6.
Industry Sector Trade Area Occupation Classification Level Competency Specialization Description
Electronics CSS NC-II Computer Systems Servicing

(For more information, indicate on a separate sheet)

11. Family Background
11.1. Spouse’s Name: JEZALYN A. DISCAYA 11.3. Occupation: PROFESSIONAL TEACHER
11.2. Educational Attainment: POST GRADUATE 11.4. Ave. Monthly Income: 21,000.00
11.5. Father’s Name:DOMINGO L. LIM 11.7. Occupation: RETIRED
11.6. Educational Attainment: COLLEGE 11.8. Ave. Monthly Income: 3,000.00
11.9. Mother’s Name:OLIVA L. TAN 11.11. Occupation: RETIRED
11.10. Educational Attainment: COLLEGE 11.12. Ave. Monthly Income: 3,000.00
11.13. Name of Guardian: JEZALYN A. DISCAYA 11.15. Occupation:PROFESSIONAL TEACHER
11.14. Educational Attainment POST GRADUATE 11.16. Ave. Monthly Income: 21,000.00
11.17. Dependents 11.18. Age Dependent Age
LEUANN JAIVYN D. LIM 3 3
(For more information, indicate on a separate sheet)