universities in the ASEAN region.

TECHNOLOGICAL
UNIVERSITY OF THE
PHILIPPINES
CONFIDENTIAL
TAGUIG CITY

The Technological University of the Philippines shall be the premiere state university with
GUIDANCE INFORMATION SHEET
recognized excellence in engineering and technology education at par with the leading FM-OSA-016 REV 0 30JAN2017

The purpose of this instrument is to gather information about student background in order to assist you
academically, socially and emotionally. The data gathered will be treated with utmost confidentiality. You are to be
specific and accurate in supplying the data.
School Year: ______________ Section: ________ Course: _________________ Student Number:_______________
Name: ______________________________________________ Age: _____________ Civil Status: ______________
Date of Birth: ___________________________ Place of Birth: ___________________________________________
Present Address: _______________________________________________________________________________
Contact Number: _________________ Provincial Address: ______________________________________________
Cellphone Number: _____________________ Physical Disability (if any): ___________________________________
PARENT’S INFORMATION FATHER MOTHER Name:
Please Check: ( ) Living ( ) Deceased ( ) Living ( ) Deceased Date of Birth / Age / / Place of Birth:
Contact Number:
Home Address:
Religion:
Occupation:
Monthly Income:
Civil Status of Parents
____ Married & Living Together _____ Living but not married ______ One Parent Living ____ Married but Separated
_____ Married and Living Together Abroad ______ Orphan, No Parent Living ____ Widowed but Remarried _____
Married and Living Together in the Province
No. of Children in the family: ________ How many brothers: _____________ How many sisters: _____________
List of Brothers and Sisters in order of birth including you:
First Name Age School/Occupation First Name Age School/Occupation 1. ________________ ______
__________________ 6. ________________ _____ _____________________ 2. ________________ ______
__________________ 7. ________________ _____ _____________________ 3. ________________ ______
__________________ 8. ________________ _____ _____________________ 4. ________________ ______
__________________ 9. ________________ _____ _____________________ 5. ________________ ______
__________________ 10. _______________ _____ _____________________ If living with guardian, Guardian’s
Name: __________________________ Relationship: _______________________ Contact Number:
________________________
Educational Background:
Year Attended Honors/ Awards Received Grade School:____________________________
______________________ _____________________________ High School: _____________________________
______________________ _____________________________ College: ________________________________
______________________ _____________________________
Organization Position Year _______________________________________ _____________________________
______________________ _______________________________________ _____________________________
______________________ _______________________________________ _____________________________
______________________
Special Skills: _________________________________________________________________________________
Hobbies: _____________________________________________________________________________________
If working student:
Name of Company: ___________________________________________ Years Connected: ___________________
Address of the Company: _________________________________________________________________________
Position: _________________________________________________ Status of Employment: __________________
Name of immediate supervisor: ____________________________________________________

__________________________ Signature over Printed Name Date: _____________________