WOODRIDGE COLLEGE WOODRIDGE COLLEG

Soldiers Hills IV, Molino, Bacoor, Cavite Soldiers Hills IV, Molino, Bacoor, Cavite

Disciplinary Referral Form Learner’s Profi

Entry Level:

PERSONAL BACKGROUND

Name of Student:

Family Name First Name

Nickname: Gend

Date of Birth: Age by

Month / Day / Year

Place of Birth: Nationality:

Religion: Baptized:

Home Address:

Contact Numbers: /

Landline

Email Address:

EDUCATIONAL BACKGROUND

School Last Attended:

School Address:

Entry Level: Graduation Date:

Class Rank: Interests:

FAMILY BACKGROUND

FATHER

Legal Father Stepfather Guardian

Foster Parent Deceased _________

Name:

Occupation:

Office Address:

Contact Numbers:

Email Address:

Religion:

Marital Status: Single Married Divorced

Who has the Custody?

Who may we call at work?

Guardian if not living with Parents: Relationship to the Child:

Home Address: Contact Number:

Brothers / Sisters Age Level School

MEDICAL AND HEALTH BACKGROUND

Any serious injury? Any operation?

Does the student have frequent (please check)

Allergies Diarrhea Menstrual Pain Asthma Dizziness

Urticaria Abdominal Pain Eye Complaints Vomiting Bleeding Tendencies

Fainting Spells Cough Convulsions Fever Colds

Difficult Breathing Headache Others:

Please check any medicine to which your child is “ALLERGIC” and/or which you do not want your child to receive.

Aspirin Imodium Simeco Mucolsolvan Bentyl

Ventolin Cremalin-HM Decolgen/Neozep Benadryl Tempr

Relestal Biogesic Midol Naprex Plasil

Antibiotic Lomotil Tylenol Alaxan Others

For external application: Hydrogen Peroxide Treatment of Iodine Betadine Solution

Is there any special condition your child suffers from or any special medication your child needs? (please specify)

When was your child’s last tetanus shot?

Has the student previously received special services? YES NO

Speech LD EMH TMH ED

In case of emergency:

Person to notify if parents cannot be reached: Contact Number:

Doctor to be notified: Contact Number:

Older siblings in school: Level & Section:

School Bus Service: Contact Number:

CERTIFICATION OF THE LEARNER AND PARENTS

I hereby certify that the information given by me in this Learner’s Profile is true and correct to the best of my
knowledge. I understand and agree that any false information, misrepresentation, or omission of facts in this Learn-
er’s Profile and the admission process may be a justification for refusal of admission, or immediate cancellation of
enrolment without recourse. I further understand and agree that all information furnished in this Learner’s Profile
and the admission process may be verified by the Woodridge College as may be necessary in arriving at the admission
to the school.
Signed:

Learner’s Signature over Printed Name Parent’s Signature over Printed Name Date
PART 4. Take a few minutes to complete the following questionnaire to assess your preferred learning style. Begin by reading the
words in the left-hand column. Of the three responses to the right, circle the one that best characterize you, answering as honestly
WOODRIDGE COLLEG
Soldiers Hills IV, Molino, Bacoor, Cavite
as possible with the description that applies to you right now. Count the number circled items and write your total at the bottom of
each column. The questions you prefer provide insight into how you learn. Learning Style Su
I grow distracted by clutter or
I get distracted by sounds, and I Assessing Your Own Learning
1. When I try to movement, and I notice things I become distracted by commotion,
concentrate…
attempt to control the amount and
around me other people don’t no- and I tend to retreat inside myself.
type of noise around me. PART 1. The Learning Style Survey1 is designed to assess your general approach
tice.
every instance, but it is clear indication of your overall style preferences. For eac
I see vivid, detailed pictures in my I see images in my thoughts that approach. Complete all items. There are 11 major activities representing 12 differe
2.When I visualize… I think in voices and sounds.
thoughts. involve movements. the statements, try to think about what you usually do when learning. It typically
3. When I talk with I find it difficult to listen for very I enjoy listening, or I get impatient I gesture and communicate with Do not spend too much time on any item—indicate your immediate feeling and mov
others… long. to talk myself. my hands.
For each item, circle your response:
4. When I contact I prefer speaking by telephone for I prefer to interact while walking
people…
I prefer face-to-face meetings. 0 = Never 1 = Rarely 2 = Sometimes
serious conversations. or participating in some activity.

I forget names but remember faces, I remember what we did together

5. When I see an I know people’s name and I can Part 1. HOW I USE MY PHYSICAL SENSES
acquaintance…
and I tend to replay where we met and I may almost “feel” our time
usually quote what we discussed.
for the first time. together. 1. I remember something better If I write it down.
I watch TV, see a play, visit an I listen t the radio, play music, I play sports, make crafts, or build 2. I take detailed notes during lectures.
6. When I relax...
exhibit, or go to a movie. read, or talk with a friend. something with my hand.
3. When I listen, I visualize pictures, numbers, or words in my head.
I enjoy the narrative most and I
I like descriptive examples and I I prefer action-oriented stories, but 4. I prefer to learn with TV or video rather than other media.
7. When I read… can almost “hear” the characters
may pause to imagine the scene. I do not often read for pleasure.
talk. 5. I use color-coding to help me as I learn or work.
I envision the word in my mind or I sound out the word, sometimes 6. I need written directions for tasks.
I get a feel for the word by writing
8. When I spell… imagine what the word looks like aloud, and tend to recall rules
it out or pretending to type it. 7. I have to look at people to understand what they say.
when written. about letter order.
8. I understand lectures better when professors write on the board.
I want verbal and written instruc-
9. When I do some- I seek out demonstrations, pic- Jump right in to try it, keep try-
thing new…
tions, and to talk it over with 9. Charts, diagrams, and maps help me understand what someone says.
tures, or diagrams. ing, and try different approaches.
someone else.
10. I remember peoples’ faces but not their names.
10. When I assemble I look at the picture first, and then, I read the directions, or I talk I usually ignore the directions and
an object… maybe, read the directions. aloud as I work.. figure it out as I go along.

11.When I interpret
someone’s I examine facial expressions. I rely on listening to tone of voice.. I focus on body language. 11. I remember things better if I discuss them with someone.
mood…
12. I prefer to learn by listening to a lecture rather than reading.
12. When I teach I tell them, write it out, or I ask I demonstrate how it is done and
other people...
I show them.
them a series of questions. then ask them to try. 13. I need oral directions for a task.

TOTAL Visual: Auditory: Tactile: 14. Background sound helps me think.

15. I like to listen to music when I study or work.

16. I can understand what people say even when I cannot see them.
WOODRIDGE COLLEGE 17. I remember peoples’ names but not their faces.
Soldiers Hills IV, Molino, Bacoor, Cavite

Admission Checklist 18. I easily remember jokes that I hear.

19. I can identify people by their voices (e.g. on the phone).

Student’s Name: Entry Level: Date of Examination:
20. When I turn on the TV, I listen to the sound more than I watch the screen.
Original and Photocopy of NSO Birth Certificate

Photocopy of the Report Card with the Ratings for the Second Quarter

Letter of Recommendation from the Principal 1 The format of the Learning Style Survey and a number of the dimensions and items are drawn from Oxford; other key dimensions and some of t

Transfer of Form 137 to Woodridge College Oxford, R.L. (1995). Style Analysis Survey. In J. Reid (Ed.), Learning Styles in the ESL/EFL classroom (pp. 208-215). Boston: Heinle & Heinle/Th

Two (2) passport size pictures Ehrman, M. E. & Leaver, B. L. (2003). Cognitive styles in the service of language learning. System 31: 393-415.
 PART 3. Read each statement and select the appropriate numbe
21. I prefer to start doing things rather than checking the directions first. 0 1 2 3 4

22. I need frequent breaks when I work or study. 0 1 2 3 4 OFTEN (3) SOMETIMES(2)

VISUAL MODALITY
23. I need to eat something when I read or study. 0 1 2 3 4
I remember information better if I write it down.
24. If I have a choice between sitting and standing. I’d rather stand. 0 1 2 3 4
Looking at the person helps keep me focused.
25. I get nervous when I sit still too long. 0 1 2 3 4
I need a quiet place to get my work done.
26. I think better when I move around (e.g. pacing or tapping my feet). 0 1 2 3 4
When I take a test, I can see the textbook page in my head.
27. I play with or bite bon my pens during lectures. 0 1 2 3 4
I need to write down directions, not just take them verbally.
28. Manipulating objects helps me to remember what someone says. 0 1 2 3 4
Music or background noise distracts my attention from the task at
29. I move my hands when I speak. 0 1 2 3 4
I don’t always get the meaning of a joke.
30. I draw lots of pictures (doodles) in my notebook during lectures. 0 1 2 3 4
I doodle and draw pictures on the margins of my notebook pages.
C - Total
I have trouble following lectures.

I react very strongly to colors.

Part 2. HOW I EXPOSE MYSELF TO LEARNING SITUATIONS
TOTAL
1. I learn better when I work or study with others than by myself. 0 1 2 3 4

2. I meet new people easily by jumping into the conversation. 0 1 2 3 4

AUDITORY MODALITY
3. I learn better in classroom than with a private tutor. 0 1 2 3 4
My papers and notebooks always seem messy.
4. It is easy for me to approach strangers. 0 1 2 3 4
When I read, I need to use my index finger to track my place on the
5. Interacting with lots of people gives me energy. 0 1 2 3 4
I do not follow written directions well.
6. I experience things first and then try to understand them. 0 1 2 3 4
If I hear something, I will remember it.
A - Total
Writing has always been difficult for me.

I often misread words from the text (i.e., “them” for “then”).
7. I am energized by the inner world (what I’m thinking inside). 0 1 2 3 4 I would rather listen and learn than read and learn.
8. I prefer individual or one-on-one games and activities. 0 1 2 3 4 I’m not very good at interpreting an individual’s body language.
9. I have a few interests, and I concentrate deeply on them. 0 1 2 3 4 Pages with small print or poor quality copies are difficult for me to
10. After working in a large group, I am exhausted. 0 1 2 3 4 My eyes tire quickly, even though my vision check-up is always fin
11. When I am in a large group, I tend to keep silent and listen. 0 1 2 3 4 TOTAL
12. I want to understand something well before I try it. 0 1 2 3 4

B - Total KINESTETIC / TACTILE MODALITY

I start a project before reading the direction.

Part 3. HOW I HANDLE POSSIBILITIES I hate to sit at a desk for long periods of time.

1. I have a creative imagination. 0 1 2 3 4 I prefer first to see something done and then to do it myself.

2. I try to find many options and possibilities for why something happens. 0 1 2 3 4 I use the trial and error approach to problem-solving.

3. I plan carefully for future events. 0 1 2 3 4 I like to read my textbook while riding an exercise bike.

4. I like to discover things myself rather than have everything explained to me. 0 1 2 3 4 I take frequent study breaks.

5. I add may original ideas during class discussion. 0 1 2 3 4 I have a difficult time giving step-by-step instructions.

I enjoy sports and do well at several different types of sports.

6. I am open-minded to new suggestions from my peers. 0 1 2 3 4
I use my hands when describing things.
A - Total
I have to rewrite ot type my class notes to reinforce the materials.
TOTAL
PART 2. To better understand how you prefer to learn and process information, place a check in the appropriate space after each 7. I focus on a situation as it is rather than thinking about how it could be.
statement below, then use the scoring directions at the bottom of the page to evaluate your responses. Use what you learn from
8. I read instruction manuals (e.g. Computers or Mobile Phones) before using the
your scores to better develop learning strategies that are best suited to your particular learning style. This 24-item survey is not
timed. Respond to each statement as honestly as you can. 9. I trust concrete facts instead of new, untested ideas.

OFTEN SOMETIMES SELDOM 10. I prefer things presented in a step-by-step way.

1. I can remember best about a subject by listening to a lecture that includes information, 11. I dislike it if my classmate changes plan for our project.
explanations and discussion.
12. I follow directions carefully.
2. I prefer to see information written on a chalkboard and supplemented by visual aids
and assigned readings.

3. I like to write things down or to take notes for visual review.

4. I prefer to use posters, models, or actual practice and other activities in class.

5. I require explanations of diagrams, graphs, or visual directions. Part 4. HOW I DEAL WITH AMBIGUITY AND WITH DEADLINES

6. I enjoy working with my hands or making things. 1. I like to plan language study sessions carefully and do lessons on time or early

7. I am skillful with and enjoy developing and making graphs and charts. 2. My notes, handouts, and other school materials are carefully organized.

8. I can tell if sounds match when presented with pairs of sounds. 3. I like to be certain about what things mean in a target language.

9. I can remember best by writing things down. 4. I like to know how rules are applied and why.

10. I can easily understand and follow directions on a map.

11. I do best in academic subjects by listening to lectures and tapes.

12. I play with coins or keys in my pockets. 5. I let deadlines slide if I’m involved in other things.
13. I learn to spell better by repeating words out loud than by writing the words on paper. 6. I let things pile up on my desk to be organized eventually.
14. I can understand a new article better by reading about it in a newspaper than by lis- 7. I don’t worry about comprehending everything.
tening to a report about it on the radio.
8. I don’t feel the need to come to rapid conclusions about a topic.
15. I chew gum, smoke or snack while studying.

16. I think the best way to remember something is to picture it in your head.

17. I learn the spelling of words y “finger spelling” them.

18. I would rather listen to a good lecture or speech than read about the same material in a
textbook. Part 5. HOW I RECEIVE INFORMATION

19. I am good at working and solving jigsaw puzzles and mazes. 1. I prefer short and simple answers rather than long explanations.

20. I grip objects in my hands during learning periods. 2. I ignore details that do not seem relevant.
21. I prefer listening to the news on the radio rather than reading the paper. 3. It is easy for me to see the overall plan or big picture.
22. I prefer obtaining information about an interesting subject by reading about it. 4. I get the main idea, and that’s enough for me.
23. I feel very comfortable touching others, hugging, handshaking, etc. 5. When I tell an old story, I tend to forget lots of specific details.
24. I follow oral directions better than written ones.

No 2 3 7 10 14 16 19 22 Visual Preference 6. I need very specific examples in order to understand fully.

Visual 7. I pay attention to specific facts or information.
Pts VPS
8. I’m good at catching new phrases or words when I hear them.
No 1 5 8 11 13 18 21 24 Audio Preference
9. I enjoy activities where I fill I the blank with missing words I hear.
Auditory
Pts APS 10. When I try to tell a joke, I remember details but forget the punch line.

No 4 6 9 12 15 17 20 23 Tactile Preference
Tactile
Pts TPS
Part 6. HOW I FURTHER PROCESS INFORMATION Part 9. HOW I DEAL WITH MULTIPLE INPUTS

1. I can summarize information easily. 0 1 2 3 4 1. I can separate out the relevant and important information in a given context ev
present.
2. I can quickly paraphrase what other people say. 0 1 2 3 4
2. When I produce an oral or written message in the target language, I make su
3. When I create an outline, I consider the key points first. 0 1 2 3 4
tures are in agreement with each other.
4. I enjoy activities where I have to pull ideas together. 0 1 2 3 4
3. I not only attend to grammar but check for appropriate levels of formality and
5. By looking at the whole situation, I can easily understand someone. 0 1 2 3 4

A - Total

4. When speaking or writing, I feel that focusing on grammar is less important t

6. I have a hard time understanding when I don’t know every word. 0 1 2 3 4 of the message.

7. When I tell a story or explain something, it takes a long time. 0 1 2 3 4 5. It is challenge for me to both focus on communication in speech or writing wh
tion to grammatical agreement (e.g., person number, tense, or gender).
8. I like to focus on grammar rules. 0 1 2 3 4
6. When I am using lengthy sentences in a target language, I get distracted an
9. I’m good at solving complicated mysteries and puzzles. 0 1 2 3 4 style.
10. I am good at noticing even the smallest details involved in a task. 0 1 2 3 4

B - Total

Part 10. HOW I DEAL WITH RESPONSE TIME

Part 7. HOW I COMMIT MATERIAL TO MEMORY 1. I react quickly in language situation.
1. I try to pay attention to all the features of new materials as I learn. 0 1 2 3 4 2. I go with my instincts in the target language.
2. When I memorize different bits of language material, I can retrieve these bits easily—as if I had stored them in 0 1 2 3 4 3. I jump in, see what happens, and make corrections if needed.
separate slots in my brain.

3. As I learn new material in the target language, I make fine distinctions among speech sounds, grammatical 0 1 2 3 4
forms, and words and phrases.

A - Total 4. I need to think things through before speaking or writing.

5. I like to look before I leap when determining what to say or write in a target lan

4. When learning new information, I may clump together data by eliminating or reducing differences and focusing 0 1 2 3 4 6. I attempt to find supporting materials in my mind before I set about producing
on similarities.

5. I ignore distinctions that would make what I say more accurate in the given context. 0 1 2 3 4

6. Similar memories become blurred in my mind; I merge new learning experiences with previous ones. 0 1 2 3 4 Part 11. HOW I DEAL WITH LANGUAGE RULES
B - Total
1. I find that building metaphors in my mind helps me deal with language (e.g

Part 8. HOW I DEAL WITH LANGUAGE RULES 2. I learn things through metaphors and associations with other things, I find

1. I like to go from general patterns to the specific examples in learning a target language. 0 1 2 3 4

2. I like to start with rules and theories rather than specific examples. 0 1 2 3 4

3. I like to begin with generalizations and then find experiences that relate to those generalizations. 0 1 2 3 4
3. I take learning language literally and don’t deal in metaphors.
A - Total
4. I take things at face value, so I like language material that says what it means

4. I like to learn rules of language indirectly by being exposed to examples of grammatical structures and other 0 1 2 3 4
language features. PART 1 PART 2 PART 3 PART 4 PART 5 PART 6 PART 7

5. I don’t really care if I hear a rule stated since I don’t remember rules very well anyway. 0 1 2 3 4 A A A A A A A
6. I figure out rules based on the way I see language forms behaving over time. 0 1 2 3 4 B B B B B B B
B - Total C