DepEd Order No. 044, s.
2021 Annex 1
Republic of the Philippines
Department of Education
Region VII, Central Visayas
Schools Division of Bohol
District of Talibon II
Talibon II Central Elementary School
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INDIVIDUAL LEARNER’S PROFILE
PART 1
Name: ____________________________________________________ Date of Birth: ______________ Age: ___________
Home Address: ______________________________________________________________________________________
Type of Learner: ____________________________________________ LRN: ____________________________________
School Year: _______________________________________________ Adviser: __________________________________
Principal: ___________________________________________________________________________________________
Record of Assessments
Date Chronological
Type of Assessment Administrator Results’Outcome
Administered Age
Attached Records of Assessment
Interview with Parents/Guardian
Name of Parents/Guardian: _________________________________________________________________________________
Contact Number/s: ______________________________________________ Date of interview: ___________________________
Developmental and Educational History:
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Interview with the Learner
Date of Interview: ______________________________________
Interest/Hobbies/Talents:
___________________________________________________________________________________________________________
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DAILY LIVING SKILLS DOMAIN: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
1
LANGUAGE DEVELOPMENT DOMAIN: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
PSYCHOMOTOR DOMAIN: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
COGNITIVE DOMAIN: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
AESTHETIC AND CREATIVE DOMAIN: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
BEAHVIORAL DEVELOPMENT: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
ORIENTATION AND MOBILITY: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
PART 2
Priority Learning Needs/Interventions:
1. ___________________________________________________________________________________________________
2. ___________________________________________________________________________________________________
3. ___________________________________________________________________________________________________
4. ___________________________________________________________________________________________________
5. ___________________________________________________________________________________________________
Transition Package
1. ___________________________________________________________________________________________________
2. ___________________________________________________________________________________________________
3. ___________________________________________________________________________________________________
4. ___________________________________________________________________________________________________
5. ___________________________________________________________________________________________________
