VUL-GCTS FORM 1
VANGUARD UNIVERSITY
LILOAN CAMPUS
GUIDANCE SERVICES CENTER
ATTACH RECENT 2X2 PHOTO
INDIVIDUAL INVENTORY RECORD FORM
Note: Please fill out the following information COMPLETELY and CORRECTLY. Rest
assured that all information in this form shall be dealt with utmost confidentiality for records
and references.
New Student Old Student Transferee Re-ad Student ID No: ___________
Course/Year/Section: ________________ Date: _______________ S.Y. and Semester: ________
I. PERSONAL INFORMATION
Name: _______________________________________________________________________ Age: _______
(Last Name) (First Name) (Middle name)
Date of Birth: ___________________ Place of Birth: ____________________________ Gender: ___________
(MM - DD - YYYY)
Height (in cm): ____________________ Weight (in kg): ___________________ Blood Type: ______________
Contact No. ________________ Telephone No. _________________ Email Address: ____________________
Permanent Address: _________________________________________________________________________
Present Address: ___________________________________________________________________________
Place where you are Home with Parents Private House Dormitory/Boarding House
staying (Please check
all applicable to you) Staying with Friends Apartment Others (please specify): ______
If working, please indicate the following: Name of Employer: _____________________________________
Address: _____________________________________________ Contact No. ____________________
Person to be contacted in case of emergency:_____________________________________________________
Address: __________________________ Relationship: ______________ Contact No. ____________________
II. EDUCATIONAL BACKGROUND
YEAR HONORS/AWARDS
LEVEL SCHOOL GRADUATED SCHOOL ADDRESS
GRADUATED RECEIVED
Pre-school
Elementary
Junior High
Senior High
Track:
Strand:
Vocational
College, if any
Nature of Schooling: Continuous Interrupted (state reasons): ___________________________
Easiest Subjects: ______________________________ Most Difficult Subjects: _________________________
Subjects with Highest Grades: __________________________________________________________________
Subjects with Lowest Grades: __________________________________________________________________
Is your present choice your personal choice? Yes No
If no, please state reasons: __________________________________________________________________
III. HOME AND FAMILY BACKGROUND
Father’s Name: _______________________________________ Age: _____ Living Deceased
Educational Attainment: __________________ Contact No. _________ Occupation: __________________
Name of Employer: ___________________________ Address of Employer: _________________________
Mother’s Name: ______________________________________ Age: _____ Living Deceased
Educational Attainment: __________________ Contact No. _________ Occupation: __________________
Name of Employer: ___________________________ Address of Employer: _________________________
Guardian’s Name: ____________________________________ Age: _____ Relationship: ____________
Educational Attainment: __________________ Contact No. _________ Occupation: __________________
Name of Employer: ___________________________ Address of Employer: _________________________
Parents’ Marital Status: Married Single Parent Divorced/Annulled Remarried
(Please Check) Lived Separated Widowed/Widower Others (please
Together specify): _______
No. of children in the family including yourself: ___ No. of Sisters: __ No. of Brothers: __ Birth Order: ___
Who finances your schooling? ___________ Relationship: __________ Parent’s Monthly Income: ________
IV. HEALTH AND PHYSICAL RECORD
Do you have problems with the following: (YES/NO), If Yes, please specify, If No, write N/A)
Your Vision: __________________ Your Hearing: ________________ Your Speech: ________________
Do you have any physical disabilities? (YES/NO, If Yes, please specify) _______________________________
Are you suffering from any health-related problems, either physically or psychologically?
(YES/NO, If Yes, please specify) _______________________________
Date of Last Hospitalization: ____________________ Reason of Hospitalization: _____________________
Do you have any medications taken regularly? Yes (please specify) _____________________________
No
V. INTERESTS AND HOBBIES
A. Academics
Math Club Science Club Photography Club Art Club
Debating Club Quizzers Club Others (please specify) ____________________
B. Extra-Curricular
List down your hobbies/sports/talents in order of your preferences.
1. __________________________ 3. __________________________ 5. __________________________
2. __________________________ 4. __________________________ 6. __________________________
Which of the following organizations you have participated in and which interest you the most?
Athletics Religious Organization Glee club Scouting
Dramatics Chess Club Others (please specify) _________________
Position in the organization: Officer Member Others (please specify) _______________
VI. PERSONAL DESCRIPTION (Tell something about yourself)
I hereby certify that above information is true and correct.
VI. SIGNIFICANT NOTES (For Guidance Counselors Only)
DATE INCIDENT REMARKS
Student’s Signature Over Printed Name Date Accomplished