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Philippine Normal University: Individual Inventory Record Form

The document appears to be an individual inventory record form for a student, requesting personal information such as name, address, family details, education background, health, hobbies, reasons for enrolling in the program, skills, and values. The form collects a range of demographic and background information to help assess and support the student. It requests details on family, living situation, education history, interests, talents, and philosophy to provide context on the applicant.

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MeAn Umali
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73 views

Philippine Normal University: Individual Inventory Record Form

The document appears to be an individual inventory record form for a student, requesting personal information such as name, address, family details, education background, health, hobbies, reasons for enrolling in the program, skills, and values. The form collects a range of demographic and background information to help assess and support the student. It requests details on family, living situation, education history, interests, talents, and philosophy to provide context on the applicant.

Uploaded by

MeAn Umali
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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Student No.

:_____________

PHILIPPINE NORMAL UNIVERSITY Paste your 2x2 Picture here


National Center for Teacher Education by virtue of RA 9647 (in semi-formal wear or smart
casual or school uniform) print
your picture in best quality
you can
INDIVIDUAL INVENTORY RECORD FORM

Date:______________________

Please PRINT clearly

My Philosophy in life:________________________________________________________________________________
I. PERSONAL INFORMATION

Name: Sex: Age:


(Surname) (First Name) (Middle Name)
E-mail:_____________________
Course: Year and Section: Civil Status:
City Address: Cellphone No.: Tel.No.:
Provincial Address: Tel.No.:
Date of Birth: Place of Birth: Religion:
If working, please indicate the name and address of Company:

II. HOME AND FAMILY

Name of Father: Age: Living: Deceased:


Educational Attainment: Occupation:
Name of Company: Address of Company:

Name of Mother: Age: Living: Deceased:


Educational Attainment: Occupation:
Name of Company: Address of Company:

Name of Guardian: Age: Living: Deceased:


Educational Attainment: Occupation:
Name of Company: Address of Company:

Parent's Marital Relationship (please Check)


[ ] Married and staying together [ ] Not married but staying together
[ ] Married but separated [ ] Other's (please specify):

Socio-Economic Status of the Family (please check)


[ ] P 5,000-Below [ ] P 15,001-P 20,000 [ ] P 30,001-P 35,000 [ ] P 45,001-P 50,000
[ ] P 5,000-P 10,000 [ ] P 20,001-P 25,000 [ ] P 35,001-P 40,000 [ ] P 50,001-Above
[ ] P 10,001-P 15,000 [ ] P 25,001-P 30,000 [ ] P 40,001-P 45,000

Number of Children in the Family including yourself: No. of Boys: No. of Girls:
Number of brothers/sisters gainfully employed: No. of Brother/s: No. of Sister/s:
Ordinal position in the Family (1st child, 2nd Child, only child):
Do you have a quiet place to study? (please check) [ ] Yes [ ] No
Do you share your room with anyone? (please check) [ ] Yes [ ] No
If yes with whom?

Nature of Residence while attending school: (please check)


[ ] Family Home [ ] Bed Spacer
[ ] Relative's House [ ] Rented Apartment
[ ] with Married Brother/Sister [ ] shares Apartment with friends
[ ] Dormitory [ ] other's (please specify)_____________________________________

cod-revised 2014
_____

___

____
III. HEALTH

Weight: Height: Complexion:

Do you have problems with (please check)


YES NO If YES, please specify
Your Vision [ ] [ ]
Your Hearing [ ] [ ]
Your Speech [ ] [ ]
Your General Health [ ] [ ]

IV. EDUCATIONAL BACKGROUND

PUBLIC/ DATES OF
LEVEL NAME OF SCHOOL LOCATION/ADDRESS
PRIVATE ATTENDANCE

Nursery
Preparatory
Elementary
High School
Senior High School
Student's NCAE Results:_______________________________________________________________________
Nature of Schooling: [ ] Continuous [ ] Interrupted, Why?______________________________________

V. HOBBIES AND INTERESTS

What are your hobbies? Write them in the order of your preference:
1 3
2 4

Which of the following organizations are you a member of? (please check)
[ ] Athletics [ ] Glee Club
[ ] Drama Club [ ] Chess Club
[ ] Religious Organization [ ] Others, please specify:

What is/are your favorite subject/s (in senior high)?


What is/are the subject/s you like least (in senior high)?

VI. REASON/S FOR ENROLLING IN PNU


1
2

VII. REASON/S FOR TAKING TEACHER EDUCATION PROGRAM


1
2

VIII. SKILLS AND TALENTS

Which of the following skills and talents do you have? (please check)
[ ] Singing [ ] Literary Works
[ ] Dancing [ ] Declamation/Oration
[ ] Driving [ ] Painting/Drawing/Sketching
[ ] Photography [ ] Cooking
[ ] Web Development [ ] Others, please specify:

IX. WHAT ARE THE THINGS YOU VALUE AND WHY?

(Student's Signature)
_________

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