ChristianJay Bardillas ProfilingForm

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Control No.

__________ Date ___________

CITY OF TALISAY LGBTQ+ FEDERATION


PROFILING
City of Talisay, Cebu

NAME Bardilas Christian Jay L


LAST NAME FIRST NAME MIDDLE NAME

Purok Ruby Dumlog Talisay City, Cebu


PRESENT
ADDRESS House No. / Street Sitio, Purok

/ / Owner / / Boarder/Rentee Length of Stay:

PREVIOUS
ADDRESS BARANGAY MUNICIPALITY/CITY PROVINCE
/ / Male CIVIL / / / / / / / / / /
SEX / / Female STATUS Single Married Widow/er Separated Common Law
Date of Birth Place of Birth: Eversley Child Sanitarium, Jagobao Mandaue City, Cebu
(mm/dd/yy) 12/15/02 Contact Number: 09912350276
E-Mail Address [email protected]
Religion: Roman Catholic

EDUCATIONAL ATTAINMENT
Level of Education School Address
Elementary Talisay City Central Elementary School
High School Talisay City National Highschool
Vocational
College/Course

EMPLOYMENT RECORD
Duration Name of Company/Employer/Address

Are you a registered voter of the barangay? / / Yes / / No

OTHER OCCUPANTS
Name Position in Date of Place of Age Civil Occupation/
the Family Birth Birth Status Educ’l Company
Last Name First Name MI ( Wife/ Son, Attainment
Daughter,
Grand Child
In – Laws,
Househelp)

Signature of Respondent: Noted by:

_________________________ Chan Nabisaga


_______________________________

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