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    GSPIS

    Uploaded by

    Aries Sunga
    The document contains a student information sheet for Jesreel Niric, who is applying as a new student to New Era University. The 3-sentence summary is: The information sheet collects personal details about Jesreel such as name, date of birth, address, family, education history, and references. It also requests a photo and signatures. The form is to be filled out by new and returning students to provide updated personal information to the university.

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

    GSPIS

    Uploaded by

    Aries Sunga
    679 views2 pages
    The document contains a student information sheet for Jesreel Niric, who is applying as a new student to New Era University. The 3-sentence summary is: The information sheet collects personal details about Jesreel such as name, date of birth, address, family, education history, and references. It also requests a photo and signatures. The form is to be filled out by new and returning students to provide updated personal information to the university.

    Original Title

    GSPIS+(1) (1)

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    The document contains a student information sheet for Jesreel Niric, who is applying as a new student to New Era University. The 3-sentence summary is: The information sheet collects personal details about Jesreel such as name, date of birth, address, family, education history, and references. It also requests a photo and signatures. The form is to be filled out by new and returning students to provide updated personal information to the university.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    679 views2 pages

    GSPIS

    Uploaded by

    Aries Sunga
    The document contains a student information sheet for Jesreel Niric, who is applying as a new student to New Era University. The 3-sentence summary is: The information sheet collects personal details about Jesreel such as name, date of birth, address, family, education history, and references. It also requests a photo and signatures. The form is to be filled out by new and returning students to provide updated personal information to the university.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Please fill up the 3 copies properly.

    For old students, fill up any changes or new data from your previous
    information.

    NEW ERA UNIVERSITY


    No. 9 Central Ave. New Era, Quezon City

    GENERAL STUDENT PERSONAL INFORMATION SHEET


    (GSPIS)

    Date(YYYY-mm-dd) : 2021-07-15 Term : 1st Sem

    STATUS : New [photo 2x2]


    DEGREE : Baccalaureate

    TEMP. STUDENT ID # : 21372147


    STUDENT ID # :
    COURSE/YEAR : Bachelor of Science in Nursing / 1 Year School Year - 2021 - 2022
    CURRICULUM YEAR : 2018 - 2019

    I - PERSONAL DATA
    First Name :Jesreel
    Last Name :Niric Middle Name: Mallari
    Nicole
    Name in Native Language Character :
    Religion : Iglesia Ni
    Gender : Female Nationality : Filipino
    Cristo
    If Alien/Foreigner, ACR No. :
    Age : 17 yrs. Date of
    Place of Birth : Magalang Pampanga
    old Birth :7/30/2003
    Civil Status : Single
    If Married:
    Woman : State Maiden's Name :
    Man : Name of Spouse :
    No. of children : 0
    Birth Order : 0

    I B - ALIEN STATUS DATA (for alien/foreigner student only)


    Visa Status Authorized Stay

    Passport number Place of Issue Expiration Date

    ACR No Date of Issue Expiration Date

    CRTS No Date of Issue Expiration Date

    II - RESIDENCE DATA
    Home Address:
    House No./Street/Barangay : 269 Centro San Pablo City/Municipality : Sta Ana
    Province/State : Pampanga Country : Philippines
    Zipcode : 2022 Telephone Nos.: 09312062477

    Current Contact Address:


    Contact Person/Guardian Name : Roda M. Niric Relation :
    Apartment Name/House No./Street/Barangay : 269 Centro San Pablo
    City/Municipality : Sta Ana Province/State : Pampanga Country : Philippines
    Zipcode : 2022 Telephone Nos.: 09312062477
    Email Address : [email protected]

    Emergency Contact Data: (if not same as above)


    Contact Person Name : Roda M. Niric Relation : Mother
    Apartment Name/House No./Street/Barangay 269 Centro San Pablo
    City/Municipality : Sta Anaemergency Province/State :Pampanga Country : Philippines
    Zipcode : 2022 Telephone Nos.:09312062477
    III - PHYSICAL DESCRIPTION
    Height :155 Weight :112 Built : Eyes :Brown Hair :Black Complexion :Fair
    Other Distinguishing Features :
    Physical Handicap or Disability (if any) :

    IV - FAMILY DATA
    Parents:
    Father’s Name :Allan B. Niric Occupation :Security
    Company Name :Telephone Nos.:09685537310
    Company Address :Pulilan Bulacan
    Father’s Email Address :
    Mother’s Name :Roda M. Niric Occupation :House Wife
    Company Name : Telephone Nos. :09685537310
    Company Address :
    Mother’s Email Address :[email protected]

    Brother(s)/Sister(s):
    NAME COURSE/OCCUPATION SCHOOL/COMPANY
    James Aldrin M. Niric Grade 11 Academia De Pulilan

    V - EDUCATIONAL BACKGROUND

    COURSE/YEAR
    NAME HONORS/AWARDS
    GRADUATED
    San Pablo Elementary 2nd Place Radiobroadcasting, 3rd Place
    Elementary Elementary 2015
    School Photojournalist
    High
    Academia de Pulilan J/S Highschool 2021 With High Honors, Leadership Award
    School
    College
    Post
    Graduate
    Vocational

    VI – GENERAL QUALIFICATION

    Languages: Filipino,English,Kapampangan
    Hobbies: Web Browsing
    Skills : Photography
    Talents : Dancing, Singing, Acting
    Sports : Volleyball
    Honors/Awards/Merits: (ex. "Model Student, 1990") : With High Honors, Leadership Award
    Extra-Curricular Activities : (Organizations, Clubs, etc) : Student Government Organization

    VII – REFERENCES

    Write two or three references who can vouch or guarantee for your total behavior.
    NAME ADDRESS
    Ka. Israel Jingco San Pablo Sta Ana Pampanga
    Mrs. Rose Guiao Pulilan Bulacan

    I HEREBY CERTIFY that the foregoing answers are true and correct to the best of my knowledge and belief.

    _________________________________________
    Student’s Signature

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