Republic of the Philippines

Department of Education
Region XII
Division of South Cotabato
PUTI ELEMENTARY SCHOOL
Brgy. Puti, Norala, South Cotabato

PUPIL’S PROFILE

Please PRINT all entries in black ballpen.

Do not leave space blank. Write N/A if not applicable.

Name of Pupil:________________________________________________________________
(Surname) (First Name) (Middle
Name)
Date of Birth: ________________________ Age: _________ Grade: _______________
Place of Birth: ___________________________________ Religion: ____________________
Language Spoken: ____________________ Talent/Skills: ____________________________
Address: ____________________________________________________________________
Father’s Name: ________________________________ Date of Birth: __________________
Place of Birth: _______________________ Educational Attainment: ___________________
Occupation: ___________________ If Employed, Where: ___________________________
Mother’s Name: _______________________________ Date of Birth: __________________
Place of Birth: _______________________ Educational Attainment: ____________________
Occupation: ___________________ If Employed, Where: ____________________________
Father’s Cell phone Number: _______________________
Mother’s Cell phone Number: _______________________
Guardian’s Cell phone Number: ______________________
Number of Children in the Family: __________
Number of Boys: _________ Number of Girls: ________

The parent is: (please check the appropriate box) Married Separated
Widow Not Married
Do you have Personal Computer/Laptop in your home: ____ Yes ___ No
Is it Internet connected? ___ Yes ___ No
Is your child suffering from any disease or sickness? ___ Yes __ No.
If yes, please specify: ________________

I hereby certify that all the above information was true and correct to the best of my
knowledge and belief.

_______________________________
Signature Over Printed Name
of Parent/Guardian
CHARISSE MAE B. MARIBONG
Class Adviser