Republic of the Philippines
Department of Education
Region IV – A CALABARZON
Division of Biñan City
District VII
San Francisco Elementary School
Tuklas St. San Francisco, Biñan City, Laguna
Guidance and Evaluation Center
INDIVIDUAL INVENTORY
PICTURE
I. PERSONAL
Name:___________________________________________ LRN:_________________
(Last Name)
(First Name)
(Middle Name)
Address: ______________________________________________________________
Gender:_______ Age:______ Date of Birth:_______________ Religion:____________
Place of Birth:__________________________________________________________
Citizenship:______________ Height:_________ Weight:___________ BMI:_________
4Ps Recepient:____ YES ____ NO
Hobby:___________________________
Ambition:______________________________________________________________
II. FAMILY DATA
Name of Father:
Date of Birth:
Place of Birth:
Religion:
Contact Number:
Educational Attainment:
Occupation:
Living: ___
or Dead:_____
Name of Mother:
Date of Birth:
Place of Birth:
Religion:
Contact Number:
Educational Attainment:
Occupation:
Living: ___
or Dead:_____
Parent’ Marital Status: _____ Married ____ Living in _____ Separated ____ Widow ____ Divorce
Student Lives with: _____ Both Parents ___ Mother only
_____ Relatives
___ Sister/Brother
_____ Father only
_____ Alone
______ Grandparents
Name of Guardian:_________________________________________ Relationship:_________________________
Date of Birth:________________________Place of Birth:______________________________________________
Religion:____________________________ Phone Number: _________________________
Educational Attainment:________________________________________ Occupation:_______________________
Economic Status: Good:_______
Moderate:____________
Low:__________
Children in the Family: Boys ____
Girls: ________
Total:__________
Birth Order: Oldest _____
Middle:______
Youngest:_______
Language Used at Home:________________________________________________________________________
III. SCHOLASTIC DATA
Grade
Level
School
School
Year
Gen. Ave.
Adviser
Number of
Attendance
Kindergarten
Grade I
Grade II
Grade III
Grade IV
Grade V
Grade VI
Complete the following statement:
1. I am happy when___________________________________________________
2. I like to __________________________________________________________
3. I am sad if _______________________________________________________
4. I don’t like _______________________________________________________
5. I am angry when _________________________________________________
6. I am afraid of ____________________________________________________
7. My family is _____________________________________________________
8. My classmate are _______________________________________________
9. My teacher is __________________________________________________
10. Our school is __________________________________________________
Greatest Strength’s: ___________________________________________________
Greatest Weakness: __________________________________________________
Plan after you graduate in Grade Six:
____________________________________________________________________
____________________________________________________________________
Ambition (s) in life: ______________________________________________________
I certify that all information I have provided above are true and correct to the best of
my knowledge.
_______________________________
Pupil’s Signature over printed name
Republic of the Philippines
Department of Education
Region IV – A CALABARZON
Division of Biñan City
District VII
San Francisco Elementary School
Tuklas St. San Francisco, Biñan City, Laguna
Guidance and Evaluation Center
PUPIL’S INFORMATION
PICTURE
Name:___________________________________________
(Surname)
(First Name)
(Middle Name)
LRN:_________________
Date of Birth:_______________
Address: ______________________________________________________________
Name of Father:________________________________________________________
(Surname)
(First Name)
(Middle Name)
Occupation:___________________________________________________________
Name of Mother:______________________________________________________
(Surname)
(First Name)
(Middle Name)
Occupation:___________________________________________________________
Guardian:_____________________________________________________________
Contact No. __________________________________
No. Of Siblings : _______________________
Parents/Relatives Working Abroad: _____ Father only ____ Mother only
_____ Both Father and Mother
_____ Grandmother
____ Uncle ____ Auntie _______ Grandfather
_______Other relatives
Country where they are working:
Father: _______________________________Work/job:_________________________
Mother:_______________________________Work/job:_________________________
Pangalan:____________________________________________________
1. Gusto mo ba na si tatay o si nanay ay nagtatrabaho sa ibang bansa?
Bakit?
_______________________________________________________
_______________________________________________________
2. Alam mo ba kung ano ang trabaho ng iyong tatay o nanay sa ibang
bansa?
_______________________________________________________
_______________________________________________________
3. Ano ang nararamdaman mo na malayo sa iyo si nanay o tatay?
_______________________________________________________
_______________________________________________________
4. Ano ang gusto mong sabihin sa iyong nanay o tatay na nagtatrabaho
sa ibang bansa?
_______________________________________________________
_______________________________________________________