Republic of the Philippines

CENTRAL BICOL STATE UNIVERSITY OF AGRICULTURE

Sta. Rosa del Norte, Pasacao, Camarines Sur, 4417
Website: www.cbsua.edu.ph
Email Address: ca.pasacao@cbsua.edu.ph
Trunkline: (054) 513-9519

STUDENT DIRECTORY FORM

Student ID no. __20- P027________Course:_BSED.GENERAL

SCIENCE________________________
Passport Size Photo
Personal Information

Name: OGUIS, HAROLD NARRA. _______ Nickname: ROLD___________

(Last, First, Middle Name)
Present Address: ZONE 2, BALOGO, PASACAO, CAMARINES
SUR_____________
Permanent Address: ZONE 2, BALOGO, PASACAO, CAMARINES
SUR___________
Age: 22____ Civil Status: SINGLE_______ Sex: _MALE__________
Date of Birth: APRIL 27, 2001___ Place of Birth: BALOGO, PPASACAO CAMARINES
SUR
Nationality: __FILIPINO____________________ Religion: _CATHOLIC__________
Telephone No.: __________ Mobile No.: 09566626017 Email Address:
oguisharold@gmail.com ________________

Family Background

Father’s Name: ARNOLD F. OGUIS_________ Age: 45_ Birthplace: BALOGO, PASACAO,

CAMARINES SUR___________________
Educational attainment: HIGH SCHOOL GRADUATE Occupation:
_______________________ Place of Work: ________________________
Living ( ) Dead ( ) Cause of Death
____________________________
Living with the Family ( ) Yes ( ✔️) No Abroad ( ) Separated ( ✔️)
Mother’s Name: _NISSA N. OGUIS__________ Age: _44_ Birthplace: PIODURAN, ALBAY,
CAMARINES SUR____________________
Educational attainment: COLLEGE LEVEL
__________________________________________________ Occupation: NONE
______________________ Place of Work: ______________________ Living ( ✔️ )
Dead ( ) Cause of Death ____________________________
Living with the Family ( ✔️) Yes ( ) No Abroad ( ) Separated ( )
Birth Order
Only Child ( ) Eldest ( ✔️) Middle Child ( ) Youngest ( ) Others: ________

Spouse’s Name _____________________________________ Occupation

________________
Educational Attainment ________________________ Age ____ No. of Dependents
________

ADM-FR-003 Rev.:1
Effectivity Date: February 12, 2024 Page 1 of 4
 STUDENT DIRECTORY FORM

Name of Siblings(Eldest- Civil

Age School/Company
Youngest) Status

HAROLD N. OGUIS 22 SINGLE CBSUA

LISLY N. OGUIS 19 SINGLE CBSUA

Housing condition: ( ✔️) Owned ( ) Shared with grandparents or relatives

( ) Rented ( ) Rent to Own

Family’s Monthly Income ( ✔️) Below P 10, 000 ( ) P 10,000-20, 00 ( ) 20, 000 –
above
Language/ Dialect Spoken at home: _TAGALOG / ENGLISH________________________

Educational Background

Elementary
Name of School _BALOGO ELEMENTARY SCHOOL Inclusive Dates
__2008/2014___
Address __ZONE 1, BALOGO, PASACAO, CAMARINES SUR__________________
Awards/Honor ____NONE_____________
Junior High School
Name of School _DR. LORENZO P. ZIGA MEMORIAL HIGH
SCHOOL______________________________ Inclusive Dates __2014/2018_______
Address _ZONE 1, BALOGO, PASACAO, CAMARINES
SUR_______________________ Awards/Honor ___NONE________________
Senior High School
Name of School __DR. LORENZO P. ZIGA MEMORIAL HIGH SCHOOL___
Inclusive Dates_2018/2020_
Address __ZONE 1, BALOGO, PASACAO, CAMARINES
SUR____________________________________________________________

Effectivity date:FEBRUARY 12,2024 Rev.:1

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 STUDENT DIRECTORY FORM

Track and Strand __TECHNICAL VOCATIONAL AND

LIVELIHOOD_________________ Awards/Honor __WITH HONORS_______________
College (for transferee/2nd courser)
Name of School ________________________________ Inclusive Dates
____________
Address _______________________________ Awards/Honor
___________________

Subject Liked Best: _______SCIENCE________ Subject Liked Least: None

Hobbies_BASKET BALL AND WATCHING ANIME
Special Talents/ Skills:
______COOKING__________________________________________________

_________________________________________________________
Clubs/Organizations Joined:
_____SPECTRUM________________________________________________

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

________________________________________________________

How do you see yourself 5 years from now? _______WORKING FOR MY DREAMS

_________________________________________________________

Health Conditions
Blood Type: ___B______________ Allergies: NONE_______________
Past/ Current Medical Conditions:
________________________________________________
Have you ever been hospitalized? __NO_____ If yes, for what reason?
____________________

In case of emergency please contact: NISSA N. OGUIS Relation: MOTHER

Effectivity date:FEBRUARY 12,2024 Rev.:1

Page 3 of 4
 STUDENT DIRECTORY FORM

Address: ZONE 2, BALOGO, PASACAO, CAMARINES SUR Contact No.09637077453

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

Signature ____________________________ Date: FEBRUARY 12, 2024

Effectivity date:FEBRUARY 12,2024 Rev.:1

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