Republic of the Philippines

CENTRAL BICOL STATE UNIVERSITY OF AGRICULTURE

San Jose, Pili, Camarines Sur 4418
ISO 9001:2015 www.cbsua.edu.ph
TÜV-R 01 100 1934918

STUDENT DIRECTORY FORM

Student ID no.: 20-0511 Course: BS Fisheries

Passport Size Photo
Personal Information
Name: BRIÑES, MARK BALINGBING Nickname: TILOY
(Last, First, Middle Name)
Present Address: ZONE 7, TAMBANG, TINAMBAC, CAMARINES SUR
Permanent Address: ZONE 7,CALTIGAO, GARCHITORENA, CAMARINES SUR
Age: 22 Civil Status: SINGLE Sex: MALE
Date of Birth: OCTOBER 2, 1998 Place of Birth: TAMBANG
Nationality: PILIPINO Religion: ROMAN
CATHOLIC Telephone No.: N/A Mobile No.: 0951-749-9152 Email Address:
mark.brines@cbsua.edu.ph

Family Background
Fathers Name: LIMUEL A. BRIÑES Sr. Age: 58 Birhtplace: CARAMORAN, CATANDUANES
Educational attainment: HIGH SCHOOL GRADUATE
Occupation: FISHERMAN Place of work: CALTIGAO,
GARCHITORENA Living ( ) Dead ( ) Cause of Death: N/A
Living with the Family ( ) Yes ( ) No Abroad ( )
Separated ( )
Mother’s Name: NATALIA B. BRIÑES Age: 60 Birhtplace: BOCOGAN, LAGONOY
Educational attainment: HIGH SCHOOL GRADUATE
Occupation: HOUSEWIFE Place of work: N/A
Living ( ) Dead ( ) Cause of Death: N/A

Birth Order
Only Child ( ) Eldest ( ) Middle Child ( ) Youngest ( ) Others: 5th in the siblings

For Married Student Only

Spouse’s Name: N/A Occupation: N/A
Educational Attainment: N/A Age: N/A No. of Dependents: N/A

Name of Siblings (Eldest- Age Civil Scholl/Company

Youngest) Status
N/A N/A N/A N/A N/A

Housing Condition: ( ) Owned ( ) Shared with grandparents or relatives

( ) Rented ( ) Rent to Own
Family’s Monthly Income ( ) Below P 10, 000 ( ) P 10, 000-20,
000 ( ) 20, 000-Above Language/Dialect Spoken at Home: BICOL
AND FILIPINO
Educational Background
Elementary
Name of School: LAGONOY NORTH CENTRAL SCHOOL Inclusive Dates: 2007-2012
Address: BALATON LAGONOY CAMARINES SUR Awards/Honor: SERVICE
AWARD
Junior High School
Name of School: BALATON NATIONAL HIGH SCHOOL Inclusive Dates:
2012-2016 Address: BALATON LAGONOY CAMARINES SUR Awards/Honor:
SERVICE AWARD
 Republic of the Philippines
CENTRAL BICOL STATE UNIVERSITY OF AGRICULTURE
San Jose, Pili, Camarines Sur 4418
ISO 9001:2015 www.cbsua.edu.ph
TÜV-R 01 100 1934918

Senior High School

Name of School: BALATON NATIONAL HIGH SCHOOL Inclusive Dates: 2016-2018
Address: BALATON LAGONOY CAMARINES SUR Awards/Honor: SERVICE
AWARD Track and Strand: (TVL) and (EIM)
TECHNICAL VOCATIONAL LIVELIHOOD and ELECTRICAL
INSTALLATION AND MAINTENANCE
Awards/Honor: SERVICE AWARD
College (for transferee/2nd courses:
Name of School: N/A Inclusive Dates: N/A
Address: N/A Awards/Honor: N/A

Subject like Best: Values Education, Music and Arts Subject Liked Least: MATHEMATICS

Hobbies: Walking, Swimming and Bathing, Cooking, Watching TV, Art (Crafting)
Special Talents/ Skill: Cooking

Clubs/Organizations Joined: N/A

Working Student? ( ) Yes ( ) No
If Yes, Name and Place of Work:

How do you see yourself 5 years from now? No one else has the ability to know our future, Only
God knows our future. But I will try my best and I do it for my studies and ‘let the God guide us.’
I like, I want, I hope and I pray, to past my studying in CBSUA-Calabanga. Because, CBSUA-
Calabanga, ‘Here’s the Processes of my fishing knowledge’s.’ After 5 years, I didn’t
expect but I think/know and I imagine that I am a good professional mechanic someday
because,of my strong dedication and trust in God Because he/she gives me an good health,
strength in life to do my daily task. And I know that this is the way to become a good and
successful man someday.

Health Conditions
Blood Type: O+ Allergies: SKIN
Past/Current Medical Conditions: N/A
Have you ever been hospitalized? N/A
If yes
for what reason?
In case of emergency please contact: JOSEPH B. BRIÑES Relation: ELDEST BROTHER
Address: ZONE 7, TAMBANG, TINAMBAC, CAMARINES SUR Contact No. 0930-
629-2967

I hereby certify that the above information is true and correct.

Signature: Date: