Learner’s Personal Data Sheet
GRADE: ___________ SECTION: ______________
LRN: ________________________________
Name of Learner : ______________________________________________________________________
Surname First Name Middle Name
Date of Birth : _____________________________________ Nickname : ______________________
Month Day Year
Gender (Male or Female): _____________ Age : ______________ Religion : ___________________
Home Address: _______________________________________________________________________
_______________________________________________________________________
4 P’s Member Yes No 4 P’s ID No. ____________________________________
Father’s Name : _________________________________ Date of Birth: __________________________
Age: _____________ Occupation:___________________________
Educational Attainment : _________________________________________________
Cellphone Number : ______________________________________________________
Mother’s Name : ________________________________ Date of Birth : _________________________
Age : _______________ Occupation : _________________________
Educational Attainment : __________________________________________________
Cellphone Number : ______________________________________________________
House Owned: ________________ House Rented : ___________________________
Total Number of Brother/s: _________________ Total Number of Sister/s : _______________
Guardian : ________________________________________ Relationship : ______________________
Date of Birth : : ________________________________ Age: __________________________
Educational Attainment : ______________________________________________________
Cellphone Number: ___________________________________________________________