Department of Education

Region IV – MIMAROPA
ORIENTAL MINDORO NATIONAL HIGH SCHOOL
(Formerly Jose J. Leido, Jr. Memorial National High School)
Division of Calapan City J. P. Rizal St., San Vicente East, Calapan City
Telefax No. (043) 288 – 8811 www.jjleidocalapan.com.ph

SENIOR HIGH SCHOOL

PERSONAL INFORMATION SHEET

LRN: __________________________ Date filled: ____________________ Date updated: __________________

Grade/Track/ Strand/Section: _________________________________ Adviser: _________________________

Name: _______________________________________________ Nickname: ____________________________

Age: _________ Date of Birth: ________________________ Place of Birth: _____________________________
Sex: Male Female Birth order among siblings ___________________
Current Address: ____________________________________________________________________________
Permanent Address: _________________________________________________________________________
Landline: ________________________ Cell phone: __________________________ E-mail: ________________
Religion from birth: __________________________________Current religion: __________________________

Mother
(mark if deceased)
Name: ____________________________
Birthdate: ____________________________
Place of birth: ____________________________
Current address: ____________________________
Contact number: ____________________________
Highest educational attainment: ____________________________
Occupation: ____________________________
Number of brothers and sisters: ____________________________
Father
(mark if deceased)
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________

Please name below siblings from eldest to youngest. Include yourself.

Name of Sibling School/Place of Work Age

_____________________________________ ____________________________________ _________
_____________________________________ ____________________________________ _________
_____________________________________ ____________________________________ _________
_____________________________________ ____________________________________ _________
_____________________________________ ____________________________________ _________
_____________________________________ ____________________________________ _________
_____________________________________ ____________________________________ _________
_____________________________________ ____________________________________ _________

PARENTS
______ Living Together ______ Temporarily Separated ______ Permanently Separated
______ Married (Civil) ______ Father OFW ______ Father with another partner
______ Married (Church) ______ Mother OFW ______ Mother with another partner

Guardian (if not living with parents): ____________________________________________________________

Address: ___________________________________________________________________________________
Landline: __________________________________ Cellphone: _______________________________________
Relationship with guardian: ___________________________________________________________________

Person to contact in case of emergency:

Name: _____________________________________________ Contact Number: ________________________

ORIENTAL MINDORO NATIONAL HIGH SCHOOL - ORIENTAL MINDORO NATIONAL HIGH SCHOOL - ORIENTAL MINDORO NATIONAL HIGH SCHOOL - ORIENTAL MINDORO NATIONAL HIGH SCHOOL