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Personal History Statement

This document is a personal history statement for a student trainee containing information such as name, age, height, weight, birthdate, address, family background, school details, emergency contact, and a certification signed by the applicant. It collects biographical information as well as educational details like the course and year being taken, length of study, department, and contact information for the OJT coordinator and dean.

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197 views1 page

Personal History Statement

This document is a personal history statement for a student trainee containing information such as name, age, height, weight, birthdate, address, family background, school details, emergency contact, and a certification signed by the applicant. It collects biographical information as well as educational details like the course and year being taken, length of study, department, and contact information for the OJT coordinator and dean.

Uploaded by

callielizza
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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OJT Form 2 Student-Trainees Personal History Statement

Republic of the Philippines


BATANGAS STATE UNIVERSITY
Batangas City

1X1
PICTURE

STUDENT TRAINEES PERSONAL HISTORY STATEMENT


Student Information
LAST NAME:
AGE:

FIRST NAME:

HEIGHT:

WEIGHT:

SEX

MIDDLE NAME:
MALE

FEMALE

COMPLEXION:

DISABILITY(IF ANY)
BIRTHDATE:

BIRTHPLACE:
(mmddyy)

CITIZENSHIP:

CIVIL STATUS:

PRESENT ADDRESS:

TEL NO.

PROVINCIAL ADDRESS

TEL NO.

Family Background(if parents are deceased give data for the nearest relative and indicate relationship to
applicant)
FATHERS NAME:

OCCUPATION:

MOTHERS NAME:

OCCUPATION:

ADDRESS OF PARENTS:

TEL NO:

GUARDIANS NAME:

TEL NO:

SCHOOL INFORMATION
COURSE:

YEAR LEVEL:

MAJOR:

LENGTH OF COURSE:

DEPARTMENT:

SCHOOL ADDRESS:

OJT COORDINATOR:

TEL NO:

OJT ASST. DIRECTOR:

TEL. NO:

DEAN/DAA:

TEL NO:

In case of emergency, notify


NAME:

RELATIONSHIP:

ADDRESS:

TEL NO:

I hereby certify that the foregoing answers are true and correct to the best to my knowledge, belief and
ability.
Signed at:____________________________ Date:____________________________

____________________________________
Applicants Signature over Printed Name

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