Hatyairatprachasun School

IP/MEP Students Profile PHOTO

First Name ______________________ Last Name _______________ Middle I. ___

Preferred Name/Nickname: _____________ Cell phone Number: ________________

Birthday ____________________(please include year) EMAIL Address:________________

Mothers name: _____________________________ CP#:_______________

Fathers name: _____________________________ CP#:_______________

Home Address __________________________________________________________

City ____________ Province __________ Zip Code ____________

Do you have access to Internet at home? (Please check) ___Yes ___No

Do you have any talent or skills? Please specify: (example:singing,dancing)

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If you have a medical issue that we should be aware of, or if you have any other
questions or concerns, please include them here: (Example: skin allergy)

______________________________________________________________________
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Interest

My favourite place in the world is ___________________________________.

My favourite sport is _____________________________________________.

My favourite movie/s is/are _______________________________________.

Someday I want to become _______________________________________.

My motto in life would be _________________________________________________.