Date:____________________

STUDENT PROFILE
Last Name: Middle Name: First Name:

LRN: Gender: 4Ps member Y______ N ____

Permanent Address: Current Address:

Birthday: Birth Place: Personal CP No.

Previous School Honor:
Interest / Hobby / Skills
Father: Occupation/ Business

Current Address CP No.

Mother: Occupation/ Business

Current Address CP No.

Guardian: Occupation/ Business

Current Address
Brothers /Sisters
Name Age Grade Course Work CP Number

Health No problem With problem Describe

Vision or Eyes
Hearing or Ears
Allergies
Breathing or heart
Others ______________

Height (m) (as of June) Weight (kl) (as of June) Height (m) (as of Feb) Weight (kl) (as of Feb)
Date:____________________