PUPILS INFORMATION SHEET
NAME:
_____________________________________________________________________
(Given Name)
(Middle Name)
(Surname)
Contact Number
: (if any) ______________________
Religion: ______________
Date of Birth
: ____________________________
Age
Place of Birth
: ______________________________________
: _______________
Complete Address : ______________________________________
PARENTS/GUARDIANS NAME
Fathers Name
: ____________________________
Age: ___________
Fathers Occupation: _______________________________________
Place of Work
: _______________________________________
Mothers Name
: ____________________________
Age: ___________
Mothers Occupation : ______________________________________
Place of Work
: _______________________________________
How Many are you in the household? : __________
CHILDREN IN THE FAMILY
Brother / Sister Name
Age
Grade/Year Level
________________________________
________
________________
________________________________
________
________________
________________________________
________
________________
________________________________
________
________________
________________________________
________
________________
________________________________
________
________________
________________________________
________
________________
Estimated Income of the Family in 1 month: Please Check () one
____ Php 500 and below
____ Php 2,001- 3,000
____ Php 5,001- 6,000
____ Php 501 1,000
____ Php 3,001- 4,000
____ Php 6,001- 9,000
____ Php 1,001 - 2,000
____ Php 4,001- 5,000
____ Php 9,001 and above