Individual Inventory Record Form

Parent's Record*

	Father's Information	Mother's Information
Name
Age
Highest Educational Attainment
Occupation
Contact Number

Children in the Family starting with the eldest (including you). Kindly put N/A if not applicable.*

Please put N/A if not applicable.*

If transferee: (Please put N/A if not applicable)*

Previous SchoolUntil what year/grade level?
Are you a member of any club/organization outside or inside the school?*

If yes, please state the club/organization and your position:

III. Health
Do you have any of the following illnesses? Please check those that affected you for the past 5 years up to present.

eye defectsear defectsasthmaheart diseasestuberculosispneumonia
Others, please specify: (please put N/A if not applicable)*
Do you have special needs and concerns (e.g ADD, ADHD, LD, etc.)? Please specify.*
Have you ever been involved in any serious accident? If so, please specify.*
IV. Career Plans
Ambition*
Goal in Life*
Occupation you are most interested in:*
V. Knowing You
Favorite Subject*
Subject you find difficult*
I learn best in:*
I think I am better when:*
To help me finish my assignment at home, I:*
What I wish to do now that I failed to do before is blanks*.
I am usually misunderstood because of my blanks*.
I deal with my problems by blanks*.
I wish my teachers would treat me blanks*.
Likes*
Dislikes*
How would you describe yourself as a learner?*
Family Concerns*
School Concerns*
Photo*
Signature*

Clear
Should be Empty:

II. Educational Background