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STUDENT-TRAINEE’S INFORMATION PROFILE

A . PERSONAL INFORMATION:

Name: ______________________________________________ Civil Status: _______________

Last First Middle

Residence Address: ______________________________________Tel. No. ________________

Province Address: __________________________________ Tel. No./Mobile No.____________

Date of Birth: _________________________________ Place of Birth: _____________________

Age: _________ Sex: ____________ Height: ________________ Weight: __________________

B. FAMILY DATA:

Father’s Name: __________________________________ Occupation: _______________

Mother’s Name:__________________________________ Occupation: _______________

Address of Parents: _____________________________________________________________

C. EDUCATIONAL BACKGROUND HIGHEST LEVEL ATTENDED:

Elementary: ____________________________________ _________________________

Secondary: ____________________________________ _________________________

Technical/Vocational: ____________________________ _________________________

College: _______________________________________ _________________________

D. IN CASE OF EMERGENCY, PLEASE NOTIFY:

Name: ________________________________________ Relationship: ______________

Address: ______________________________________ Tel. No. __________________

I hereby certify that the information given above are true and correct to the best of my knowledge.

_____________________________
Printed Name & Signature