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Guidance Form 1-Student-Inventory-Form-converted

The document is a Student's Inventory Form from the Department of Education in the Philippines, designed to collect personal, educational, and family information from students. It includes sections for personal data, parental information, educational background, and problems encountered at home or school. Additionally, it requests a sketch of the student's home location relative to the school.

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CARICRIS MARATA
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4 views

Guidance Form 1-Student-Inventory-Form-converted

The document is a Student's Inventory Form from the Department of Education in the Philippines, designed to collect personal, educational, and family information from students. It includes sections for personal data, parental information, educational background, and problems encountered at home or school. Additionally, it requests a sketch of the student's home location relative to the school.

Uploaded by

CARICRIS MARATA
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Guidance Form 1

Republic of the Philippines


Department of Education
Region VII, Central
Visayas
DIVISION OF LAPU-LAPU CITY

(Name of School) Pictu

re
GUIDANCE AND COUNSELING OFFICE
1x1
STUDENT’S INVENTORY FORM

Instruction: Please fill in this inventory form with the necessary data. Likewise, put a check mark () or specify
the needed information on the item that necessitated it.

STUDENT’S PERSONAL DATA

Name:
Family Name First Name Middle Name

Present Home Address: Grade Level/Section:


Nick Name: Age: Gender:
Date of Birth: Place of Birth:
Nationality: Religion:
Rank in the Family: No. of Sister(s): No. of Brother(s):
Living with: ( ) Both Parents ( ) Father Only ( ) Mother Only
( ) Others
Contact Number: Email Address:

PARENTS/GUARDIAN’S DATA:

Father’s Name: Living ( ) Deceased ( )


Present Home Address:
Occupation: Contact Number:
Mother’s Name: Living ( ) Deceased ( )
Present Home Address:
Occupation: Contact Number:
Guardian’s Name: Living ( ) Deceased ( )
Present Home Address:
Occupation: Contact Number:

PARENT’S MARITAL STATUS

( ) Church marriage ( ) Civil marriage ( ) Living together without marriage


( ) Separated ( ) Single parent ( ) Others _______ _ (pls. specify)

STUDENT’S EDUCATIONAL DATA

Level Name of School last Attended Year Awards and Honors


Received
Primary School
Elementary
Secondary: Junior
High School

Subject/s with Lowest Grades: Subject/s with Highest Grades:


Plans after Senior High School:
Awards/Honors Received:
Guidance Form 1

Preferred College/ University: (FOR SENIOR HIGH SCHOOL ONLY)


Name of College/ University Course
1.
2.
3.

Special Skills: Club/Organization:

PROBLEM ENCOUNTER

At Home: In/Off- Campus

( ) Inadequate food to eat ( ) Bullied by other persons


( ) Generation Gap ( ) Peer Pressure
( ) No proper place to study ( ) Complying project & assignment
( ) No enough time to study ( ) Understanding the Subject matter(s)
( ) Working out values ( ) Teacher(s) unacceptable personalities
( ) Seeking Independence ( ) Corporal Punishment
( ) Parent’s Financial Problem ( ) Verbal Abuse or Insults
( ) No house/home to claim dwelling ( ) Emotional concern (crush/puppy love)
( ) Identify Crisis Disclosure ( ) Inadequate food to eat
( ) Sharing sensitive/ Personal Issues ( ) Classroom/students’ congestion
( ) Too much household chores ( ) Hard quizzes and examination
( ) Proper time to sleep/rest ( ) Temptation in any unacceptable act(s)
( ) Physical absence of parent(s) ( ) Identify crisis disclosure
( ) Physical harm ( ) Sharing sensitive/personal issues
( ) Sexual Harassment ( ) Monetary Contributions
( ) Parent(s) punishment ( ) Unfriendly environment/ people
( ) Verbal abuse & insults ( ) Sexual Harassment
( ) Others: ( ) Others:

HOUSE LOCATION SKETCH


Please write a sketch of your home address from the school. Provide notable landmarks.

“It is only with the heart that one can see rightly, what is essential is invisible to the
eye.” (The Little Prince, Antoine deSaint-Exupery)

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