Form 1B – GSTC – R2021 COURSE, YEAR LEVEL & SECTION: ___________

TAGUM DOCTORS COLLEGE, INC.

Mahogany St., Rabe Subd., Visayan Village, Tagum City
tdci.guidance@gmail.com; www.facebook.com/tdci.guidance
Guidance Services and Testing Center 2 x 2 Photo

Student Inventory Updating Form

(Grade 12, 2nd Year to 4th Year)

Student ID No: ___________________

I. PERSONAL INFORMATION
Name: ___________________________________________________Sex: ____ Age: ___ Civil Status: _________
(Surname) (First Name) (Middle Name)
Course (College): ___________________ Year Level (SHS): ______ Date of Birth: _________ Height: ______ Weight: _____
Place of Birth: ________________ Present Address: _________________________________________________________
Email Address: __________________________ Religion: ________________Mobile No: ____________________________
Person to contact in case of Emergency: __________________________ Relationship: ______________________________
Address: ____________________________________________________Contact No: _______________________________

II. HOME AND FAMILY BACKGROUND

Father’s Name: _________________________________ Age: ____________ [ ] Living [ ] Deceased
Educational Attainment: __________________________ Occupation: ____________________________________

Mother’s Name: ________________________________ Age: ____________ [ ] Living [ ] Deceased

Educational Attainment: __________________________ Occupation: ____________________________________

Guardian’s Name: _______________________________ Age: ____________ Relationship: __________________

Address: _______________________________________ Occupation: ___________________________________

Parent’s Marital Relationship:

[ ] Single Parent [ ] Married & Staying Together [ ] Not married but living together
[ ] Married but Separated [ ] Others (Please Specify) __________________

Who finances your schooling? [ ] Parents [ ] Spouse [ ] Relatives [ ] Brother/Sister

[ ] Scholarship [ ] Self-Support

How much is your total family income per month? (Combined monthly income of your father, mother, and other working members
of your family) Please check below.

[ ] below P10, 000 [ ] P10, 000 - P20, 000 [ ] P20, 001 – P30, 000 [ ] P30, 001 – P40, 000
[ ] P40, 001 – P50, 000 [ ] above P50, 000

Do you have a quiet place to study? [ ] Yes [ ] No

Do you share a room with anyone? [ ] Yes [ ] No

III. HEALTH
A. Physical
If you have problems with the following aspect, please check: [ ] Vision [ ] Hearing [ ] Speech
[ ] General Health [ ] others, please specify: __________________
B. Psychological (please check):
Consulted Yes No When Reason

Psychiatrist

Psychologist

Counselor

IV. INTERESTS and HOBBIES

Favorite Subject/s: ______________________________________
Least Favorite Subject/s: _________________________________
What are your hobbies? Write them in order of your preferences:
1. ____________________ 3. _____________________
2. ____________________ 4. _____________________

Which of the following organizations have you participated in and which interests you the most?

[ ] Athletics [ ] Peer Counselors Club [ ] Student Club/Organization

[ ] Religious Organization [ ] Others (Please Specify)

_______________________________
(Student’s Signature over Printed Name)
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Tagum Doctors College, Inc. Guidance Services & Testing Center