Republic of the Philippines

BATANGAS STATE UNIVERSITY

JPLPC Campus
Malvar, Batangas

COLLEGE OF TEACHER EDUCATION

STUDENT TEACHER’S
PERSONAL HISTORY STATEMENT

PERSONAL DATA
Full Name: Gega, Rose Ann T.
Physical Description: Age : 29 Sex: Female Height : 4’11
Weight: 148 kg Complexion: Fair Disability, of any: None
Date Birth: November 22, 1987 Place of Birth: Mabitac Laguna
Citizenship: Filipino Status: Married
Present Address: 110 San Juan, Malvar Batangas Tel. / Cell No.:09215014451
Provincial Address: 110 San Juan, Malvar Batangas Tel / Cell No.: 09215014451

FAMILY BACKGROUND:
Father’s Name: Lorenzo Tasico Occupation: Deceased
Mother’s Name: Josephine Tasico Occupation: STL Agent
Address of Parents: 110 San Juan, Malvar Batangas Tel. No. 09487606074
Guardian’s Name: Leonel Gega Tel. No. 09289578566

SCHOOL DATA
Course: Bachelor of Secondary Education Year Level: 4
Major: English Length of Course: 4 years
Department: CTE
School Address: Poblacion, Malvar Batangas
Training Coordinator: Ms. Nora V. Marasigan Tel.No.
Associate Dean: Dr. Rubilyn M. Latido Tel. No.

IN CASE OF EMERGENCY, NOTIFY

Name: Leonel R. Gega Relationship: Spouse
Address: 110 San Juan, Malvar Batangas Tel. No. : 09289578566

I HEREBY CERTIFY THAT THE FOREGOING INFORMATION IS TRUE

AND CORRECT TO MY KNOWLEDGE, BELIEF AND ABILITY.

Signed at : ____________________________________ Date: _____________________

___________________________________
Signature over Printed Name of Student