Guidance Form 3

Republic of the Philippines

BOHOL ISLAND STATE UNIVERSITY
Balilihan Campus
Magsija, Balilihan, Bohol

Vision: A premier Science and Technology university for the formation of world class and virtuous human resource for sustainable development
in Bohol and the Country.
Mission: BISU is committed to provide quality higher education in the arts and sciences, as well as in the professional and technological fields;
undertake research and development and extension services for the sustainable development of Bohol and the country.

INDIVIDUAL INVENTORY FORM

Dear Student,
The purpose of this form is to gather essential information that will enable your Guidance Counselor to help
you in whatever way possible. Be assured that all information shall be kept with utmost confidentiality.

Date: ____________ A.Y. 20___- 20___

Student Number/I.D. Number: _______________________ Course: ______________________

______________________________________________________________________________________
(Family Name) (First Name) (Middle Name) (Nickname) 2x2 Picture
Age: ________ Gender: _______________________ Civil Status: ________________ ______________ (Not a cut out.)
Date of Birth: _______________________ Place of Birth: _________________________________
Religion: ____________________________ Nationality: ____________________________________
Mobile #: __________________________________ Tel. #: ___________________________________
Email Address: ______________________________________________________________________
City Address: __________________________________________________________________________________________________________
Home Address: ________________________________________________________________________________________________________

FATHER MOTHER
Name
Home Address
Contact Number
Date of Birth
Nationality
Educational
Attainment
Occupation
Place of Employment
Monthly Income

Parents
___ Living Together ___ Permanently Separated ___ Temporarily Separated
___ Father – OFW ___ Mother – OFW

Name of Brothers/Sisters Age School/Place of Work

Place + sign after name, if deceased.

Guardian (if not living with Parents): _________________________________________________________________________________________

Relationship with Guardian: __________________________________________ Contact #: ____________________________________________
Address: _________________________________________________________________________________________________________________________

Easiest Subjects: ________________________________________________________________________________________________________________

Difficult Subjects: _______________________________________________________________________________________________________________
Guidance Form 3

Inclusive Years Honors/Awards

Name & Address of School
of Attendance Received
Elementary
Secondary
Tertiary*
______________________
_
Graduate Studies*
______________________
_
*Please write the degree and major.

Name of Organization/s that You are a Member of Position School Year

Interests: ________________________________________________________________________________________________________________________
Skills/Talents: ___________________________________________________________________________________________________________________
Hobbies: _________________________________________________________________________________________________________________________
Ambitions: _______________________________________________________________________________________________________________________
Present Concerns: ______________________________________________________________________________________________________________
Fears: ____________________________________________________________________________________________________________________________
Philosophy/Motto in Life: ______________________________________________________________________________________________________
Traits that You Possess:
Friendly ( ) Easily Troubled ( ) Happy-Go-Lucky ( )
Stubborn ( ) Confident ( ) Calm ( )
Relaxed ( ) Imaginative ( ) Practical ( )
Tense ( ) Suspicious ( ) Trusting ( )
Worrier ( ) Serious ( ) Shy ( )
Reserved ( ) Outgoing ( ) Dominant ( )
Self-assured ( ) Perfectionist ( ) Flexible ( )
Individualistic ( ) Group-Oriented ( ) Traditional ( )
Others (Please specify.): ________________________________________________________________________________

Disabilities/Impairments: ______________________________________________________________________________________________________
Chronic Illnesses: _______________________________________________________________________________________________________________
Medicines Regularly Taken: ____________________________________________________________________________________________________
Accidents Experienced/Effect: _________________________________________________________________________________________________
Operations Experienced/Effect: _______________________________________________________________________________________________

To whom would you like to share your concerns and problems with? Why?
____________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________

Would you like to see and talk to your guidance counselor?

____________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________

____________________________________________
Signature over Printed Name