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LEARNERS INVENTORY PROFILE Matatag Footer

learners invob=velment in seminar

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Andoy Andrew
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24 views3 pages

LEARNERS INVENTORY PROFILE Matatag Footer

learners invob=velment in seminar

Uploaded by

Andoy Andrew
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Education
REGION IV-A CALABARZON
SCHOOLS DIVISION OFFICE OF LAGUNA
B.N. CALARA INTEGRATED NATIONAL HIGH SCHOOL
LOS BAŇOS, LAGUNA

INDIVIDUAL INVENTORY RECORD FORM


(Source: PUP Guidance Counseling and Testing
Services)

Date Gathered

I.PERSONAL INFORMATION

Name: Gender: Age:


(Last Name) (First Name) (Middle Name) Civil Status:
Grade & Section: Track/Strand: Date of Birth:
Height (m): Weight (kg): Complexion: Place of Birth:
Current Address: Email Add.:
Previous General Ave.: Religion: Mobile#:
If working, please indicate the name and address of the employer:

Person to be contacted in case of accident or serious illness:


Address:
Relationship: Contact #:

II. EDUCATIONAL BACKGROUND


LEVEL SCHOOL SCHOOL PUBLIC/ DATES OF HONORS
GRADUATED ADDRESS PRIVATE ATTENDANCE RECEIVED/SPECIAL
AWARD
Pre-Elem

Elementary

JHS

SHS

Nature of Schooling Continuous Interrupted, why?

III. HOME AND FAMILY BACKGROUND


FATHER MOTHER
Name
Educational Attainment

Birth Date
Living
Occupation
Name of Employer
Address

Address: Carbern Village Barangay Anos, Los Baños, Laguna


E-mail: 342353@deped.gov.ph
Contact Nos.: (049) 501-3412
Facebook: www.facebook.com/DepEdTayoBNCINHS342353
Republic of the Philippines
Department of Education
REGION IV-A CALABARZON
SCHOOLS DIVISION OFFICE OF LAGUNA
B.N. CALARA INTEGRATED NATIONAL HIGH SCHOOL
LOS BAŇOS, LAGUNA

Parents’ Marital Relationship (Please check)


Married and staying together Not Married but living together Single Parent
Married but separated Others(please specify)

Number of children in the family including yourself No. of Brothers No. of Sisters

Ordinal Position (1st child, 2nd Child etc. No. of brothers/sisters currently employed
Are your brothers/sisters currently working to support your (please check)
family your studies his/her own family
Who finances your schooling?
Parent Spouse Scholarship
Brother/Sister Relatives Self Supporting Working Student

How much is your allowance? (please specify the amount)


Parents’ Total Monthly Income:
Below Php5,000 Php 15,001-Php 20,000 Php 30,001-Php 35,000 Php 45,001-Php 50,000
Php 5,001- Php 10,000 Php 20,001-Php 25,000 Php 35,001-Php 40,000 Above Php 50,001
Php 10,001-Php15,000 Php 25,001-Php 30,000 Php 40,001-Php 45,000 Others please specify

Do you have a quiet place to study? (Please Check) [ ] Yes [ ] No


Do you share your room with anyone? (Please Check) [ ] Yes [ ] No, If yes with whom?
Nature of Residence while attending school: (Please Check)
family home bed spacer
relative’s house rented apartment
shares apartment with friends dorm (including board & lodging
/relatives (Please Underline) house of married brother/sister

IV.HEALTH (please attached medical certificate if any)


A Physical
Do you have problems with (Please Check)
YES NO YES NO
Your Vision Your Speech
Your Hearing Your general health

B. Psychological
Previous Consultations
CONSULTED YES NO WHEN FOR WHAT?
Psychiatrist

Psychologist

Counselor

Address: Carbern Village Barangay Anos, Los Baños, Laguna


E-mail: 342353@deped.gov.ph
Contact Nos.: (049) 501-3412
Facebook: www.facebook.com/DepEdTayoBNCINHS342353
Republic of the Philippines
Department of Education
REGION IV-A CALABARZON
SCHOOLS DIVISION OFFICE OF LAGUNA
B.N. CALARA INTEGRATED NATIONAL HIGH SCHOOL
LOS BAŇOS, LAGUNA

V. INTEREST AND HOBBIES

A. Academic
Math Club Sciences Club Others, please specify:
Debating Club Dance Club

What is/are your favorite subject/s?


What is /are the subject/s you like least?

B.Extra-Curricular
What are your hobbies? Write them in the order of your preferences.

1. 3.

2. 4.
Which of the following organizations have you participated in and which interest you
most? (Please specify)
Athletics Religious organization Glee Club Dramatics
Chess Club Scouting Others, please specify
Occupational position in the organization: Officer Member
Others, please specify
Occupational position in the organization: Officer Member

Others, please specify

VI.Significant notes (please attached communication CARDEX if any)

Signature above Printed Name

Address: Carbern Village Barangay Anos, Los Baños, Laguna


E-mail: 342353@deped.gov.ph
Contact Nos.: (049) 501-3412
Facebook: www.facebook.com/DepEdTayoBNCINHS342353

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