AC Application Form

CESB application form for assessment center

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Preferred AC Date:

CAREER EXECUTIVE SERVICE BOARD

No. 3 Marcelino Street, Holy Spirit Drive, Diliman, Quezon City 1127
Tel. Nos. 951-4981 to 85 (Trunkline) • 951-4983 or 951-3306 (Fax)
Website: www.cesboard.gov.ph

_______________
(AC Form Revised as of Feb. 28, 2018)

ASSESSMENT CENTER APPLICATION FORM
Full Name: (Surname, First name & Middle name)
Date of Birth:

Age:

Gender:

Civil Status:

Appointed Position:

Religion:
Salary Grade:

Current Position (if designated to other position):

Date of Designation:

Agency/Office:
Office Address:
Home Address:
Office Phone No.:

Fax No.:

Mobile No.:

E-mail Address:

In case of emergency, please notify (indicate contact number):

Date of Written Exam (MATB/CEOE): __________ Supervisory Experience(No. of years/months) ___________
PLEASE CHECK APPROPRIATE BOX/ES.





First Time to Undergo AC
Master in National Security Administration (MNSA)
Master in Public Safety Administration (MPSA)
Career Service Executive Eligible (CSEE)

 AC Re-taker
 Date of previous AC:______________________

APPLICATION PROCESS
1. Accomplish AC application form and send to CESB at Fax Nos.: (02) 951-4983 / 951-3306 or thru e-mail
address: [email protected]/[email protected] Kindly verify from CESB if form was properly
received.
2. All applications received by CESB shall be evaluated and processed in accordance with existing policies
and standards. Since CESB can only accommodate 24 examinees per conduct, confirmation of
participation will be on a FIRST COME, FIRST SERVED BASIS. CESB shall officially notify applicants of
their AC schedule.
3. For MNSA, MPSA, CSEE and AC Re-takers, kindly submit the following documents together with this form:
 Latest Appointment Paper
 Service Record
 Office Order indicating designation to a third level position
 Certificate of Eligibility (for CSEEs only)
4. For further information, you may call the Eligibility and Rank Appointment Division (ERAD) at (02) 9514981 locals 118/832 or visit our website: www.cesboard.gov.ph for updates.
This is to certify that the above information is true and correct.
I hereby confirm my intention to undertake the Assessment Center
on the date provided by the Career Executive Service Board.
________________________________
SIGNATURE OVER PRINTED NAME

_________________
DATE