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    Bupc Student Profile Form

    Uploaded by

    John Chicogo
    This document is a student profile form used by Bicol University Polangui Campus Office of Guidance Services. It collects personal information about the student such as name, date of birth, address, as well as contact information. It also gathers information about the student's family background including parents' names, ages, occupations and income. Additionally, it documents the student's educational history and health records like immunizations, allergies and illnesses. The form is used to develop a comprehensive profile of each student.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Bupc Student Profile Form

    Uploaded by

    John Chicogo
    37 views4 pages
    This document is a student profile form used by Bicol University Polangui Campus Office of Guidance Services. It collects personal information about the student such as name, date of birth, address, as well as contact information. It also gathers information about the student's family background including parents' names, ages, occupations and income. Additionally, it documents the student's educational history and health records like immunizations, allergies and illnesses. The form is used to develop a comprehensive profile of each student.

    Original Title

    BUPC STUDENT PROFILE FORM

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    © © All Rights Reserved

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    This document is a student profile form used by Bicol University Polangui Campus Office of Guidance Services. It collects personal information about the student such as name, date of birth, address, as well as contact information. It also gathers information about the student's family background including parents' names, ages, occupations and income. Additionally, it documents the student's educational history and health records like immunizations, allergies and illnesses. The form is used to develop a comprehensive profile of each student.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    37 views4 pages

    Bupc Student Profile Form

    Uploaded by

    John Chicogo
    This document is a student profile form used by Bicol University Polangui Campus Office of Guidance Services. It collects personal information about the student such as name, date of birth, address, as well as contact information. It also gathers information about the student's family background including parents' names, ages, occupations and income. Additionally, it documents the student's educational history and health records like immunizations, allergies and illnesses. The form is used to develop a comprehensive profile of each student.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 4

    Bicol University Polangui Campus

    Office of Guidance Services


    Polangui, Albay
    Email:bupcguidance@gmail.com

    STUDENT PROFILE FORM


    I. PERSONAL INFORMATION
    1. Name 7. Telephone No.

    (Last) (First) (Middle ) 8. Contact No.


    PHOTO
    2. Date of Birth 9. Email Address 2X2

    3. Place of Birth 10. Religion

    4. Gender 11. Nationality

    5. Civil Status 12. Spouse (if any)

    6. Address 13. Occupation

    II. FAMILY BACKGROUND


    Father Mother Guardian

    Name Total Annual Family Below P 60,000 a year

    Age Income P 60,001 to P 100,000 a year

    Religion P 100, 001 to P 150,000 a year


    Nationality Above P 150,000 a year

    Educational Status of Parents Married

    Attainment

    Not Married

    Occupation Married, living Apart

    Position/ Living Together

    Employer

    Separated

    Office Address Legally Separated

    Contact No. Father Remarried

    living living Relationship:________ Mother Remarried


    deceased deceased ___

    Name of Siblings Age Educational Attainment Occupation Name of Child/ren Age Highest Grade Completed

    III. EDUCATIONAL RECORD


    Level Name of School Degree/Course Year Graduated Inclusive Dates of Attendance Scholarship/ Awards/ Honors
    Received
    From To
    Kindergarten

    Elementary

    Junior High School

    Senior High School

    College

    Please sketch the specific location of your house, including landmarks near it for easy
    IV. SPECIAL RECORD
    identification. If you are a boarder please sketch the location of your boarding house

    A. Friends in School Address Contact Number/s

    B. Friends outside School Address Contact Number/s

    During school days, I stay in: with: no one My present course is influenced by

    on our own house whole family relative/s own choice friend/s


    relative’s house
    both parents friend/s parent’s choice relatives
    rented house/ apartment
    father spouse teacher media
    rented room
    mother child/ren guidance counselor
    boarding house
    sibling/s in- laws person who will finance my studies
    dormitory room
    guardian/s landlord/lady scholarship available

    I attend parties: Always Frequently Seldom Never

    Do you have a part time job? YES (where?___________________) NONE (Do you like to have one?_______)
    V. Health Record
    Allergies No Yes (Specify:___________) Family Diseases: (Please check) Past Disease/s:

    Medication No Yes (Specify:___________) Cancer Heart Disease High Blood Pressure

    Physical Defects No Yes (Specify:___________) Diabetes Peptic Ulcer Nervous Breakdown

    Eye glasses/Contact Lens No Asthma: No Yes Epilepsy Tuberculosis Others:______________________

    Yes Describe vision problem:______________________ Types Date Result

    Measles DPT(Diphteria, pertussis, Tetanus) Psychological

    Immunization Record Mumps BGC (Anti-TB) Others:________ Test Record

    Rubella OPV(Polio)

    BU-F-OSAS –SWSD-02 Rev. 3

    Effectivity Date: June 5, 2018

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