OUR LADY OF LOURDES HIGH SCHOOL, INC.
School Year: ____________________
GUIDANCE OFFICE
INDIVIDUAL INVENTORY
Junior High School
I. PERSONAL DATA
Name: ___________________________________________________Gr. & Sec.: __________________ Student No.: __________________
Date of Birth: _____ /_____ /_________ Place of Birth: ____________________________________________ Age: ______ Sex: _________
Ordinal Position in the Family (Please Check)
{ } Eldest { } Middle { } Youngest { } Only Child { } Others: ____________________________________________
Address: __________________________________________________________________________________________________________
Contact Number: _______________________________________ Email Add: __________________________________________________
II. FAMILY DATA
Father Mother
(mark with *if deceased) (mark with *if deceased)
Name
Age
Educational Attainment
Occupation
Parents
Living together Temporarily separated
Permanently separated Father OFW
Marriage annulled/legally separated Mother OFW
Father with another partner Mother with another partner
Others (please specify)
Please name below your siblings from eldest including yourself.
Put a check mark (√) before the name to indicate that he/she is your stepbrother and/or stepsister. While an (x) mark to indicate the he/she
is deceased.
Sister/Brother
Sex Age Occupation Civil Status Educational Attainment
(from eldest to youngest)
III. EDUCATIONAL DATA
Level School Honors/Awards
Kinder
Elementary
*For Junior High School
transferee
You are best at (name of subjects): _____________________________________________________________________________________
You struggle at (name of subjects): _____________________________________________________________________________________
What course do you want to take up in college?
1st choice: _____________________________________________ 2nd choice: _______________________________________________
IV. HEALTH CONDITION
Have you suffered from any illness? _____ What kind? ____________________________________________________________________
Have you been hospitalized? _____ How long? __________________________________________________________________________
When was your last visit to the doctor? _________________________________________________________________________________
V. PERSONAL DATA
I believe that I have the ability to ______________________________________________________________________________________
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When I was a child _________________________________________________________________________________________________
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I look forward to my future as ________________________________________________________________________________________
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VI. HOBBIES AND INTEREST
What do you do during your breaktime?
{ } sport { } singing { } others (please specify ___________________ )
{ } watching TV/movies { } playing computer games
{ } reading { } dancing
VII. AREAS OF CONCERN
Self-development
I need to…
{ } know and understand myself better { } manage my time
{ } develop self-confidence { } plan my life
{ } get rid of personal vices/uncontrollable habits: { } others (please specify ___________________________________ )
Please underline (drugs, alcohol, stealing, gambling, violence, smoking, computer addiction)
Family relationship
I hope to…
{ } improve my relationship with my siblings { } help parents manage their problems
{ } develop the ability to discuss problems with my parents { } hope to earn respect and attention from my family
{ } cope with expectation and demands of parents/guardians { } others (please specify ___________________________________ )
{ } relate with step parents/step siblings (please underline)
Social relationships
I desire to…
{ } develop skills for starting/maintaining friendship { } to express my true self to others
{ } know how to choose friends and avoid bas influence and bullying { } be presentable to others
{ } others (please specify __________________________________ )
Studies
I aim to…
{ } develop effective study habits { } learn my lessons with parents
{ } develop confidence in recitation and discussion { } apply the values that I’ve learned
{ } talk to teacher about difficulty in understanding lesson { } others (please specify ___________________________________ )
VIII. SELF-EXPRESSION ESSAY
My biggest concern at the moment is __________________________________________________________________________________
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