This document contains a student's personal information including name, address, contact details, family background, educational history, and answers to various questions. The student provides their name, birthdate, address, family member names and occupations, emergency contact, languages spoken, grade school attended and average grades, relationship status, interests, dreams, and self-assessment in one word. They rate their former school's education quality and answer questions on strengths, weaknesses, influences on studies, experiences with teachers, and skills.

1. I. PERSONAL INFORMATION (Write in all capital letters.)
NAME: __________________ __________________ __________________ NICKNAME: __________
(Family Name) (Given Name) (Middle Name)
HOME ADDRESS: ______________________ ______________________ _______________________
(Barangay) (Municipality) (Province)
BIRTHDAY: ____________ ______ _______ BIRTHPLACE: ______________ __________________
(Month) (Day) (Year) (Town/City) (Province)
GENDER: __ Male __ Female __ Gay __ Lesbian __ Bisexual AGE: ____
CELLPHONE NUMBER: __________________ E-MAIL ADDRESS: ______________________________
RELIGION: _____________________________ NATIONALITY: ________________________________
FATHER’S NAME: _______________________ OCCUPATION: ___________________ AGE: ______
MOTHER’S NAME: ______________________ OCCUPATION: ___________________ AGE: ______
PARENTS’ CONTACT NUMBER: __________________________ NUMBER OF SIBLINGS: ___________
PERSON TO BE CONTACTED IN CASE OF EMERGENCY: ____________________________________
CONTACT NUMBER: ____________________ RELATIONSHIP: ________________________________
LANGUAGES SPOKEN: __________________________________________________________________
II. EDUCATIONAL BACKGROUND
GRADE SCHOOL GRADUATED: __________________________ YEAR GRADUATED: ____________
GRADE 7: _____________________________________________ GEN. AVERAGE: _______________
GRADE 8: _____________________________________________ GEN. AVERAGE: _______________
III. RELEVANT QUESTIONS
* Are you from a broken family? ___ Yes ___ No
* Which type of family do you have? ___ Nuclear Family ___ Extended Family
* Have you ever incurred a failing grade before? ___ Yes ___ No
* What’s your strength as a student? ____________________________________________________
* What’s your weakness as a student? __________________________________________________
* What subject interests you most? ____________________
* What makes it interesting? ____________________________________________________________
* What are the three qualities of teacher you like best? __________________________________
* Was there a bad experience you had with your former teacher/s? ___ Yes ___ None
* If yes, please elaborate: ______________________________________________________________
* Have you ever been called at the Guidance Office for misbehavior? ___ Yes ___ Never
* Do you think having boyfriend/girlfriend can affect one’s studies? ___ Yes ___ No
* Choose your specialization/skills (Check at least three)
___ Speaking ___ Singing ___ Cartooning ___ Designing
___ Writing ___ Directing/Leader ___ Video Editing ___ Cooking
___ Dancing ___ Acting ___ Photography ___ Hosting
* What is your greatest dream? _________________________________________________________
* How do you rate the quality of education in Manaoag NHS? (Check one)
___ Excellent ___ Very Satisfactory ___ Satisfactory ___ Poor
* Describe your self in one word: _______________________
I hereby certify that the above information is true and accurate.
_________________
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