CARE CENTER

STUDENT INFORMATION INVENTORY SHEET

PERSONAL DATA

Profile Picture:

LRN Number:

Last Name:

First Name:

Middle Name:

Grade Level:

Section:

Gender:

Religion:

Citizenship:

Indigenous People (IP):

4P's Beneficiary:

Birth Date:

Birth Place:

Age:

Birth Order:

Tribe/Ethnicity:

Contact Number:

Email Address:

Present Address:

Provincial Address:

Type of Residence in the City:

Person/s supporting your studies:

Weekly Allowance:

If sufficient, type N/A. If not sufficient type No, and then why?:

EMERGENCY CONTACT

Complete Name:

Relationship:

Address:

Contact No.:

FAMILY BACKGROUND

Family Status:

Father's Name: Father's Occupation: Working Abroad:
Yes No

Father's Citizenship: Father's Religion: Father's Contact Number: Father's Employer/Address: Highest Educational Attainment:

Mother's Name: Mother's Occupation: Working Abroad:
Yes No

Mother's Citizenship: Mother's Religion: Mother's Contact Number: Mother's Employer/Address: Highest Educational Attainment:

EDUCATION & PLANS

Educational Background

Level	School Name	Address	Type	Year
Pre-school
Elementary
High School

Senior High Track Choice:

Chosen by:

Difficulties/Struggles:

Academic Awards:

Interests:

CHILDREN/SIBLINGS

Check if student has NO siblings

Name	Age	Education	Occupation