Mary Help of Christians School Cebu, Inc.

Km. 17, Tunghaan,Minglanilla

GUIDANCE OFFICE

COMPREHENSIVE INDIVIDUAL INVENTORY RECORD

CONFIDENTIAL
(Entry of Record)
SCHOOL YEAR:_____________
GRADE LEVEL:_____________
I.LEARNER’S PERSONAL DATA

Name:_____________________________________________________________ Nick Name:____________

(Surname) (First Name) (Middle Name)
Sex:_______ Age:____ Birth day:_____________ Birth Order:_____ Nationality:__________ Religion:__________
Family Size: (What composed the current household)
__________________________________________________________________________________________
Home Address: _________________________________________Telephone No.______ Cell No._______________

II. FAMILY BACKGROUND

Name of Father :_____________________________________Age:___ Birthday: __________

Nationality:________
Highest Educational Attainment:____________________________ Occupation:_____________________________
Company :_______________________________
Company Address:______________________________________

Name of Mother:_____________________________________ Age:___ Birthday: __________

Nationality:_______
Highest Educational Attainment:_____________________________ Occupation:____________________________
Company:________________________________ Company Address:_____________________________________

Name of Guardian:___________________________ Relationship to child:____________ Age:___ Birthday:______

Highest Educational Attainment:_______________________________ Occupation:__________________________

III. MARITAL STATUS OF PARENTS

() Living Together but Mother working Abroad () Separated/ Single Parent
() Living together but Father working Abroad ()Living together and both parents working in the Philippines
() Living together but both parents working abroad () Others (specify) _________________________________

IV.CHILDREN IN THE FAMILY (from the eldest to the youngest including the respondent, indicate if adopted)

First Name Age Educational Attainment Occupation Status

 V.SCHOOL HISTORY (of the child)

School level Name of School Address Inclusive Dates Honors/Awards

Kinder

Grade 1
Grade 2
Grade3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10

Extra Curricular activities in school:____________________________________________________________________

Out of school Activities:_____________________________________________________________________________
Skills/Talents: _____________________________________________________________________________________

With parent’s guidance, I affirm that all information given are true and correct. Records received are held with utmost
confidentiality

___________________________________ _________________________________________
Student’s Signature over printed name* Guidance Counselor ‘s Signature over printed name
*For Kinder to Grade 3 students, their parents/legal guardian will be the one to sign.