Consolatrix College of Toledo City

Magsaysay Hills, Toledo City

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COLLEGE CUMULATIVE RECORD

Student No._______
Course & Year:__________

Name of Student:_______________________________________________________________________
Family Name Given Name Middle Name
Citizenship________________________ Religion___________________________ Age_____________
Date of Birth______________________ Place of Birth________________________________________
Home Address:____________________________________________ Phone No.___________________
Hobbies:_____________________________________________________________________________
Motto:_______________________________________________________________________________

B. FAMILY CULTURAL BACKGROUND

Father Mother
Complete Name
Religion
Date of Birth
Age
Citizenship
Occupation
Office Address
Phone. No.
Educational Attainment

Ordinal position in the family_____________________________________

No. of brothers______________________________ No. of Sisters_______

In case of emergency please notify:

_____________________________________________________________________________________
Name of Person Address Phone No.

Please Check:

Parents Marital Status:_____ Married in Church_____ Civil Marriage______ Live-in_____ Separated

Parent’s is living with?________ Both Parents______ Mother only______ Father Only_____ Guardian

Area where you grow- up?______ Residential_______ City_______ Industrial________ Province

Who finances your studies?_______ Parents_______ Self________ Other; Specify__________________

C. EDUCATIONAL ATTAINMENT

School Name and Address Year Graduated

Elementary____________________________________________________ ___________________
High School___________________________________________________ ___________________
Co- Curricular activities, Organizations/ Affiliations/ Awards Citations and Honors received while in
HighSchool___________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

D. COMMUNITY

Year Level Name of Organization Position Head

E. INTERVIEWS AND COUNSELING

Date Time Findings and Comments Referred by:

___________ ______________ _________________________________ ___________________

___________ ______________ _________________________________ ___________________
___________ ______________ _________________________________ ___________________
___________ ______________ _________________________________ ___________________
___________ ______________ _________________________________ ___________________
___________ ______________ _________________________________ ___________________
___________ ______________ _________________________________ ___________________
___________ ______________ _________________________________ ___________________
___________ ______________ _________________________________ ___________________
___________ ______________ _________________________________ ___________________
___________ ______________ _________________________________ ___________________

F. TEST RECORD

Name of Instrument Date Score Percentile I.Q Remarks

Administered Rank
 Consolatrix College
Magsaysay Hills, Toledo City
Individual Interview
College Department

Name:___________________________________ Nickname:______________________
Age:___________ Birthday: _________________Date today:_____________________
I. Educational Attainment:
A. Year Name of School Year Graduated
First Year ___________________________________ _________________
Second Year ___________________________________ _________________
Third Year ___________________________________ _________________
Fourth Year___________________________________ _________________
B. Highest Grade Obtained Honors Received
First Year ___________________ %
Second Year ___________________ %
Third Year ___________________ %
Fourth Year___________________ %
C. Civic Activities Participated:
_____________________________________________________________________
_____________________________________________________________________
D. Religious Activities Involved:
_____________________________________________________________________
_____________________________________________________________________
E. Why are you interested to study in Consolatrix College?
_____________________________________________________________________
_____________________________________________________________________
F. Why are you interested to take up Education/ Computer/ HRM?
_____________________________________________________________________
_____________________________________________________________________
G. Is there someone who influenced your decision?
_____________________________________________________________________
H. What were your achievements in Elementary? In High School?
_____________________________________________________________________
_____________________________________________________________________
I. Family Status
A. Are you living with your parents? ______________________________________
B. Who supports your education? ________________________________________
C. Do you have brothers and sisters? ______________________________________
D.
Name of brothers and sistersAge Educational Attainment
_______________________ _______ _____________________________
_______________________ _______ _____________________________
_______________________ _______ _____________________________
_______________________ _______ _____________________________
J. Personality
A. Special Ability ( pls. Check)
Writing _____ singing ______ Speaking ____ Dancing _____ Others specify_______
B. Hobbies (Interest)
____________________________________________________________________
____________________________________________________________________
II. Physical Health
Height ______________ weight _____________ Blood Type ____________
Allergies _____________________________________________________________
Accidents encountered: Date:
_____________________________________ ________________________
Hospitalization:
_____________________________________ ________________________
Remarks:
_____________________________________________________________________