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NPCMST Guidance Inventory Form School Year 2021 - 2022

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NPCMST-ACA-G-001

NORTHERN PHILIPPINES COLLEGE FOR MARITIME SCIENCE AND TECHNOLOGY


Lingsat, City of San Fernando, La Union

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NPCMST Guidance Inventory Form
School Year 2021 - 2022
I. PERSONAL DATA
Surname First Name Middle Name

Program
BACHELOR OF SCIENCE IN
Year Level Old Student New Student Sex
Transferee

Home Address with Zip Code

Boarding House Address with Zip Code

Civil Status Religion Birthday

Language/ Dialect Spoken Place of Birth Age

Email Ad Facebook Account Contact Number

Name of Husband/Wife if married Occupation Contact Number

Complete Address with Zip Code

II. FAMILY BACKGROUND


Name of Father Educational Attainment Occupation

Name of Mother Educational Attainment Occupation

Contact Number of Father Contact Number of Mother Contact Number of Guadian

Name of Brothers and sister in order (Include yourself)


1. 4. 7.
2. 5. 8
3. 6. 9.
Name of Guardian (If not living with parent) Relationship

Complete Address with Zip Code Contact Number of Guardian

III. EDUCATIONAL BACKGROUND


Elementary Years Attended Honor/Awards

High School Years Attended Honor/Awards

Other Schools Years Attended Honor/Awards

General Average Favorite Subjects

Course Preference

Reasons for Choosing NPCMST

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GUIDANCE OFFICE
NPCMST-ACA-G-001

NORTHERN PHILIPPINES COLLEGE FOR MARITIME SCIENCE AND TECHNOLOGY


Lingsat, City of San Fernando, La Union

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How are studies being supported?


By Scholarship (Please specify the type of
(please check) scholarship)
By Parents
By Relatives
Other Means
IV. OTHER RELEVANT INFORMATION
Membership in Organization Interest/Talents/Hobbies

Are you working or a self-supporting student? Yes No


If working, what is the nature of your job? Nature/Position of Job Place of job

Did you stop schooling? Yes No

When? When?

Reasons

Have you been convicted of any crime or delinquent acts? Yes No

When? When?

Nature Nature

Are you living with your parents? Yes No

Why?

Are you living in a boarding house? Yes No


If you are living in a boarding house, what are the problems
you are encountering?
V. FAMILY INCOME LEVEL
What is family income level per month? (In pesos) (in pesos)
(please check) 6,000 – 6,999 11,000 – 11,999
7,000 – 7,999 12,000 – 12,999
8,000 – 8,999 13,000 – 13,999
9,000 – 9,999 14,000 – 14,999
10,000 – 10,999 15,000 and above/
OTHER Source of Income

Student Picture

_______________________________
Student Signature

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GUIDANCE OFFICE

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