DepED - National Capital Region

Division of City Schools - Valenzuela

Valenzuela Central District
LINGUNAN ELEMENTARY SCHOOL

STUDENT PROFILE
Name of Student:
Last Name First Name Middle Name
Complete Address:
Date of Birth: Age: Sex:
Place of Birth: No. of Siblings:
Religion: Birth Order:
Mother's Name: Occupation:
Highest Educational Attainment: Contact No.:
Father's Name: Occupation:
Highest Educational Attainment: Contact No.:

Status of Parents: Married Single Parent

Separated Widower
Living Together

Socio Economic Status:

Below 5,000 15,000-19,000
5,000-9,000 20,000-29,000
10, 000-14,000 30,000-Above

Ownership (House and Lot): Others:

Owned Rented (Pls. Specify)

Member of 4Ps:
Yes No

In case of Emergency, Please Contact:

Name of Parent/Guardian: Relationship

Address: Contact No.:

I hereby declare that all the facts afore-mentioned are true to the best of my knowledge and I bear respobsibility to
the information provided in this form.

Name of Parent/Guardian

Date Signed