Professional Documents
Culture Documents
INTAKE FORM
NAME: ZEEK RICCI R. MADRIGAL NICKNAME: EPOY SEX: MALE
ADDRESS:183 REPARO ST BAESA CALOOCAN NATIONALITY: FILIPINO BLOOD TYPE: O
CITY
AGE: 19 YEARS OLD BIRTH DAY: 12/13/00 LANGUAGE: TAGALOG HEIGHT: 5’5
PLACE OF BIRTH: MANILA PROVINCE: LA UNION WEIGHT: 63
; Personal information
; Family Background
NAME RELATION AGE SEX OCCUPATION/SCHOOL
BABY RICCI R. MADRIGAL MOTHER 40 F NONE
ALDRIN A. MADRIGAL FATHER 39 M NONE
EZER A. CANETE STEP 41 M NONE
FATHER
SHEKAINAH A. CANETE STEP 18 F 1ST YEAR COLLEGE
SISTER
REEZ RICCI R. CANETE STEP 14 F 2ND YEAR HIGH SCHOOL
SISTER
SKY RICCI R. CANETE STEP 11 M SPED SCHOOL
BROTHER
MAKI ILLAYA P. MADRIGAL STEP 5 M NONE
BROTHER
; HEALTH
MEDICAL HISTORY ASTHMA / DENGUE / ALLERGY / OPERATION
COMMON ILLNESS ASTHMA / ALLERGY
CURRENT HEALTH SITUATION HEALTHY AND WELL GOOD
; EDUCATION BACKGROUND
ELEMENTARY 2006-2012 OUR LADY OF LOURDES COLLEGE
HIGH SCHOOL 2012-2016 ST. BERNADETTE COLLEGE OF VALENZUELA
SENIOR HIGH SCHOOL 2016-2018 OUR LADY OF FATIMA UNIVERSITY
CURRENT COLLEGE SCHOOL UNIVERSIDAD DE MANILA
; LIFE EXPERIENCE
BASKETBALL VARSITY ELEMENTARY GREW UP ON STREET
; Physical appearance
Mid size of height Black color eyes
Has a skin asthma Not drinking alcohol
Not smoking cigarette Jolly person
Into sports Into music
; Problem presented
I’m always experiencing Family problem, I have a broken family which it’s not a problem to me when I
was young, but now when I grow up, I’m always asking myself if my life is worthful and I always
experiencing being jealous to other complete family. Separated family is hard you always think and
wondering what’s the feeling on having a complete family. Every time I have award on school
academically or into sports I always wanted to be with my mother and father when claiming the awards
like my other classmates.