( ATTACHED PHOTOCOPY any of PSA OR NSO or LOCAL BC and recent picture)
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region I
Division of Ilocos Sur
TAGUDIN DISTRICT
GARITAN INTEGRATED SCHOOL
PUPILS PROFILE
LRN:________________________
NAME:_________________________________________________________________________________________________
Surname Given Name Middle Name
ADDRESS:_______________________________________________________________________________________________
BIRTHDAY:________________________________ BIRTHPLACE:___________________________________________________
AGE:___________ RELIGION:_____________________ DIALECT/LANGUANGE SPOKEN:_________________________
WEIGHT: ____________ HEIGHT 1:___________ HEIGHT 2: ___________ BMI:_________
FATHER’S NAME: ____________________________________________Age: _______ BIRTH DATE: ______________________
BIRTH PLACE:__________________ EDUC. ATTAINMENT:_____________________________OCCUPATION: _______________
MOTHER’S NAME:___________________________________________Age: ________ BIRTH DATE:_______________________
MOTHER’S MAIDEN NAME:_____________________________________________
BIRTH PLACE:_________________________ EDUC. ATTAINMENT:_______________________OCCUPATION: _______________
NO. OF CHILDREN: ______ BOY _______ GIRLS
CONTACT NUMBER/S: ________________________________________
# Books No. ______________________
K12 BOOKS ISSUED RETURNED
ENGLISH
MATH
SCIENCE
FILIPINO
EDUKASYON SA PAGPAPAKATAO
EDUKASYONG PANTAHANAN AT PANGKABUHAYAN
ARALING PANLIPUNAN
MUSIKA AT SINING
P.E AT HEALTH
TOTAL
KASUNDUAN: Anumang gamit ng paaralan lalo na ang mga aklat ay dapat pag-ingatan. Anumang bagay na nasira
Ng inyong mga anak ay kinakailangan ayusin o palitan. Ang mga aklat na nasira o nawala habang ito ay nasa
pangangalaga ng inyong mga anak ay kinakailangan ayusin o palitan kapag ito ay nawala. (DepEd Order.#25, s2003)
___________________________________
PARENTS NAME AND SIGNATURE
Date:
______________________
Adviser