Document Code: GTC- F- -15 SPR
MANUEL S. ENVERGA UNIVERSITY Document Title: Student Personnel Record
FOUNDATION – CANDELARIA, INC. Page No: 1 of 3
Candelaria, Quezon Revision:
Effectivity Date:
GUIDANCE & TESTING CENTER Prepared by: Guidance and Testing Center
Reviewed by:
QUALITY FORM Apprpved by:
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(2x2)
STUDENT PERSONNEL RECORD
Admitted to the College of: Select Admitted: Select
Course School Year
PERSONAL DATA
Name:
(Family Name) (Given Name) (Middle Name) (Sex)
Home Address:
No. Street Subdivision Town Province
Date of Birth:
Month Day Year Height
Place of Birth:
Town Province Weight
Nationality: Religion: Civil Status:
Contact Number: Residence Tel. Number:
EDUCATIONAL DATA
Name of School Inclusive Years
Elementary
Junior High School
Senior High School
College
Are you a working student? Yes No
If so, where do you work? On Campus Off campus Both
Do you work more than one job? Yes No
How many hours do you work per week? 1-10 11-15 16-20
21-35 36-40 41+
Nature of Work
Please indicate your primary reason for working:
I have to work in order to pay for some/all of my college and personal expenses.
I work for extra spending money.
I work for the experience; it will help me get a job after I graduate.
I work to support myself and/or my family.
I enjoy my job/working.
Other (Please specify)
EXPECTATIONS IN COLLEGE
Please check those that apply to you
I want to earn a college degree because…
I want to make a good salary after I graduate. I want the world to be a better place.
I want to move ahead in life. I do not plan to earn a degree.
I need it for my career plans. I do not know.
I like to learn for learning’s sake. Other (Please specify)
It was an expectation that I earn one.
Document Code: GTC- F- -15 SPR
MANUEL S. ENVERGA UNIVERSITY Document Title: Student Personnel Record
FOUNDATION – CANDELARIA, INC. Page No: 2 of 3
Candelaria, Quezon Revision:
Effectivity Date:
GUIDANCE & TESTING CENTER Prepared by: Guidance and Testing Center
Reviewed by:
QUALITY FORM Apprpved by:
Please indicate the number of colleges/universities that you applied to before applying to MSEUF Candelaria.
1-3 3-6 more than 6
This university was my Select choice.
First Second Third None of the above
When making your decision as to which university to attend, how important were the following factors?
Factors Very Moderately Slightly Not At All Not
Important Important Important important Applicable
Overall academic reputation of the college
Social life reputation of the college
Campus activities offered
Campus size
Geographic location
Parental influence
Peer influence
Financial aid offered
Campus safety
Institutional type (public or private)
Cost
RECREATION-LEISURE/INTEREST
Below is a list of activities. Check those which you enjoy doing. (You can choose more than 1)
Swimming Viewing Television Chess
Table Tennis Volleyball Chinese Checker
Badminton Parties Others (Specify)
Basketball Picnics/Outings
Do you play any musical instrument? Yes No
If yes, check the instrument you play.
Guitar Banduria Accordion
Piano Trumpet Organ
Lyre Bugle Others (Specify)
Clubs/Organization/Extra-Curricular Activities (in and out of school)
Position since When
1.
2.
3.
4.
5.
FAMILY BACKGROUND
Father’s Name: Living [ ] Deceased [ ]
Age: Religion Occupation:
Educational Attainment:
Mother’s Name: Living [ ] Deceased [ ]
Age: Religion Occupation:
Educational Attainment:
Parent’s Marital Status
Married Separated Single Parent
Number of children in the family including yourself?
Your position in the family? Eldest Youngest Middle Child Only child
Family Income (Monthly)
Below P6000 P20,000-P25,000
P10, 000-P15,000 P25,000-P30,000
P15, 000-P20,000 P30,000 and above
Do you have any disability or impairment? Yes No if so what it is?
Hearing Orthopedic
Visual Others (please specify)
When you experience some problems, to whom do you usually go? Please check (/) those that apply to you.
Mother Friends
Father Counselor
Elder Sister Teacher
Elder Brother Priest
Grand Parents Others (specify)
Does your family attend church services or mass? ? Yes No
If yes, does the family do it regularly? Yes No
Name of person to be contact in case of emergency:
Relationship: [Link]/Cellphone No.:
Address:
Signature of Student Date Submitted
