Republic of the Philippines

Department of Education
Region VI-Western Visayas
Division of Negros Occidental
FLORENTINA CAÑA RECTO MEMORIAL NATIONAL HIGH SCHOOL
CALILING EXTENSION
Caliling, Cauayan,Negros Occidental

LEARNER’S PROFILE

Name: _____________________________________________ Date of Birth: ____________________ Gender: ______

Home Address: _____________________________________________________________________________________
Distance of Home to School (km): _________________________________
Name of Father: _____________________________________ Occupation: ___________________________________
Name of Mother: ____________________________________ Occupation: ___________________________________
Annual Family Income: _________________ Number of Siblings: (M) _____ (F) ______ Sibling Position: ___________
How many siblings who are in school? __________________ How many are not? _____________________________
Risk factors manifested: ______________________________ Remarks: _____________________________________
Intelligences Possessed: ______________________________________________________________________________
Personality: ________________________________________ Remarks: _____________________________________
Interests: __________________________________________________________________________________________
Reading Level: _____________________________________ Numeracy Level: _______________________________
Neighbor Schoolmates: ______________________________________________________________________________
__________________________________________________________________________________________________
Person/s to Contact in case of emergency: _________________________ Contact Number(s): ______________________

Map of Residence (From School to Home):