STUDENT INDIVIDUAL INVENTORY
All fields are required, but if the information is not available you can input "-" or "n/a". By providing the personal data below, the student agrees that the same shall be used by the institution, solely for educational purposes. In no case shall the data provided be disclosed except to partner organizations in compliance with contractual obligations or pursuant to law. Finally, it is understood that the personal details provided below may be used to assess student life.
Student Name
*
First Name
Middle Name
Last Name
Suffix
Grade Level
*
Please Select
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Section
*
Please Select
St. Cecilia
St. Catherine
St. Gertrude
St. Elizabeth
St. Rose
Age
*
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Phone Number
*
Please enter a valid phone number.
Student Email Address
*
example@example.com
Gender
*
Male
Female
Nationality
*
Religion
*
Please Select
Roman Catholic
Christianity
Iglesia ni Cristo
Seventh Day Adventist
Muslim
Others
Who are you staying with?
*
Please Select
Parents
Siblings
Auntie/Uncle
God Parents
Grandparents
Others
Educational Background
*
School Name
Year
Honors Incured
Elementary
Secondary
Family Background
*
Full Name
Educational Attainment
Contact Number
Occupation
Mother
Father
Monthly Family Income
*
below Php 10,000.00
Php 10,000-20,000.00
Php 20,000-30,000.00
above Php 30,000.00
Back
Next
Parent's Relationship Status
*
Married and living together here in the Philippines
Married and living together but one is working abroad
Married but separated here in the Philippines
Both are working abroad
Separated with other families
Separated without having each a family
Both with other partners
Both without partners
Not Married
Deceased
Siblings
Full Name
Age
Educational Attainment
Occupation
1
2
3
4
5
6
7
8
In Case of Emergency:
Who can we contact?
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Health
Let's talk about your health!
Height
*
Weight
*
Blood Type
*
Please Select
A+
B+
AB+
A-
B-
AB-
O+
O-
I don't know
Answer the following honestly
*
No
Yes
Answer
Are you suffering from any ailments or handicap?
Are you under any medication?
Did you have any suicidal attempts or thoughts? if yes, when?
Were you a victim of any form of abuse? If yes, when?
Did you get involved with illegal drugs? If yes, when?
Do you have a mentally challenged family member/relative? If yes, how are you related to her or him
Have you visited a psychiatrist or psychologist before? If yes, state the reason.
Submit
Should be Empty: