Liceo de Cagayan University

Senior High School - Main Campus

Office of the Prefect of Discipline and Student Affairs
School Year 2022 - 2023

STUDENT'S INFORMATION SHEET

Pairat Aura Jannary Sheene Bautista
Last Name Given Name Middle Name Suffix (Jr./II)
Grade 11 - STEM 16 FEMALE Month: JANUARY Day: 20 Year: 2006
Grade Level & Section Age Gender Date of Birth
Cagayan de Oro City Protestant O+
Place of Birth Religion Blood Type
Bisaya Higa-onon 5 Ft. 1 Inches 51 kg 112.436 lbs.
Mother Tongue IP (Ethnic Group) Height (in Feet and Inches) Weight (in Kilograms)

Contact Details of the Student LRN:

Complete Home Address: Block 1 Lot 22D, Buena Oro
House # / Street / Sitio / Purok
Macasandig Cagayan de Oro City Misamis Oriental
Barangay Municipality / City Province
Draw both sketches of your home and present addresses at the back of this page, highlighting important landmarks and specifying transportation details.

Complete Present Address: Block 1 Lot 22D, Buena Oro Macasandig

Street Barangay
Cellphone No: 0912 - 139 - 7976 Email Address: ajspairat22744@liceoedu.ph
First 4 digits Mid 3 digits Last 4 digits

Telephone No: Facebook Account: Aura Pairat

In case of emergency, who is the best person to contact?
Name: Jesser T. Pairat Cellphone No: 0936 - 855 - 1613
First 4 digits Mid 3 digits Last 4 digits

Relationship with student: Daughter Office Number:

Contact Details of the Parents/Guardian

Mother's Maiden Name: Pairat Annabelle Bautista
Last Name First Name Middle Name
Occupation: OFW Cellphone No: 8529 - 072 - 4655 Office No:
First 4 digits Mid 3 digits Last 4 digits
Business / Company Address:
Father's Name: Pairat Jesser Tagaylo
Last Name First Name Middle Name
Occupation: Teacher Cellphone No: 0936 - 855 - 1613 Office No:
First 4 digits Mid 3 digits Last 4 digits
Business / Company Address: 27th-28th Sts. Nazareth Cagayan de Oro City
Name of Guardian: Jesser T. Pairat Cellphone No: 0936 - 855 - 1613
First 4 digits Mid 3 digits Last 4 digits

Occupation: Teacher Office Number:

Business / Company Address: Cagayan de Oro National High School - JH
Email Address of all or any of the parents/guardian: jepa060667@gmail.com

Other Relevant Information

List down the names of your siblings / relatives / schoolmates studying in Liceo U and living in your neighborhood:
Name Year & Section Name Year & Section
1. Aldous Justine John B. Pairat 1sy Year College 3. N/A
2. N/A 4. N/A

Specimen signatures of: (Please sign thrice to establish signature consistency / identity.)

Father

Mother

Guardian

I hereby certify that all data written herein are true and correct to the best of my knowledge.

Signature of Student