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    Iir-Revised Sy 2020-2021

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    Elisa Medina Albino
    This document is an individual inventory record for a grade 5 student named Albino Ishmael Medina from Elizabeth Seton School. It contains personal information about the student like name, birthdate, address, family members, languages spoken at home. It also asks for information on the student's strengths, interests, preferences, academics, behavior, and career plans. The parents are asked to provide this information to help the Center for Student Well-being identify any needs or concerns to address and to be part of the student's cumulative record.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Iir-Revised Sy 2020-2021

    Uploaded by

    Elisa Medina Albino
    19 views2 pages
    This document is an individual inventory record for a grade 5 student named Albino Ishmael Medina from Elizabeth Seton School. It contains personal information about the student like name, birthdate, address, family members, languages spoken at home. It also asks for information on the student's strengths, interests, preferences, academics, behavior, and career plans. The parents are asked to provide this information to help the Center for Student Well-being identify any needs or concerns to address and to be part of the student's cumulative record.

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    IIR-REVISED SY 2020-2021

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    This document is an individual inventory record for a grade 5 student named Albino Ishmael Medina from Elizabeth Seton School. It contains personal information about the student like name, birthdate, address, family members, languages spoken at home. It also asks for information on the student's strengths, interests, preferences, academics, behavior, and career plans. The parents are asked to provide this information to help the Center for Student Well-being identify any needs or concerns to address and to be part of the student's cumulative record.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    19 views2 pages

    Iir-Revised Sy 2020-2021

    Uploaded by

    Elisa Medina Albino
    This document is an individual inventory record for a grade 5 student named Albino Ishmael Medina from Elizabeth Seton School. It contains personal information about the student like name, birthdate, address, family members, languages spoken at home. It also asks for information on the student's strengths, interests, preferences, academics, behavior, and career plans. The parents are asked to provide this information to help the Center for Student Well-being identify any needs or concerns to address and to be part of the student's cumulative record.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    ELIZABETH SETON SCHOOL

    Center for Student Well-being


    INDIVIDUAL INVENTORY RECORD

    Grade/Year & Section: 5 - Catanduanes Student Number: 201810120 1x1 recent


    ID picture
    House Name (HS only): School Year: 2020 - 2021 here
    Year/Level Started in ESS: Grade 2 Academic Strand (SHS only):

    The learner’s personal information is used exclusively by the Center of Student Well-being to help identify
    needs and concerns that can be addressed by the center. The information you are asked to provide will
    be part of the learner’s cumulative record. All information will be kept strictly confidential. Please be honest
    and sincere in answering this form to enable us to better understand your child.

    I. STUDENT’S PERSONAL INFORMATION

    Name: Albino Ishmael Medina Nickname: Ishi


    (Last) (First) (Middle)
    Address: #15 Pioneer St. Moonwalk Subd. Las Pinas City
    Birthdate: May 29, 2010 Place of Birth: Las Pinas Birth Order: second-born
    Nationality: Filipino Religion: Catholic Telephone No.: 82960618
    Mobile No.: Email Address: [email protected]

    II. FAMILY BACKGROUND


    Father Mother
    (as reflected on the learner’s (as reflected on the learner’s Guardian
    birth certificate) birth certificate)
    Gary T. Albino Elisa M. Albino
    Name
    Master's Degree College
    Educational Attainment
    Architect House Wife
    Occupation
    09283392858 09995669562
    Contact Number
    [email protected] [email protected]
    Email Address

    Name of Sibling/s If alumni, indicate what batch in


    Birthdate Level / Occupation
    (Eldest – Youngest) ESS / College Degree and School
    Angel M. Albino Mar.5, 2005 Grade 10

    Althea M. Albino Feb. 14, 2012 Grade 3

    Athena M. Albino June 18, 2019

    OTHER PERSON/S STAYING AT HOME


    Name Relationship Contact Number
    Resan P. Azucena Housemaid 09102866520

    Child lives with: ✔ Both Parents Father Mother Guardian Relative


    Supervision of School Work: ✔ Father ✔ Mother Tutor Others
    Language/s or Dialect/s Spoken at Home: English and Tagalog
    ELIZABETH SETON SCHOOL
    Center for Student Well-being
    INDIVIDUAL INVENTORY RECORD

    III. PERSONAL CHARACTERISTICS


    (Your child’s adviser may see your comments on this portion)

    1. What strengths, interests and preferences does your child have?


    Perseverance, he doesn't give up easily

    Strengths

    Drawing, building legos, watching movies, loves creating things, listening to music
    Interests

    He likes building things

    Preferences

    2. What does your child need to improve on in terms of the following…


    Science, Filipino, Math
    Academics

    N/A
    Behavior

    Career Plans
    *JHS/SHS learners only

    3. Do you have special concerns about your child? If yes, kindly specify how the guidance counselor/ level
    mentor can help him/her.
    N/A

    4. Has your child consulted with a medical professional / outside specialist for any challenges or concerns he/she
    might have? If yes, kindly indicate assessment and recommendations.
    N/A

    5. Please list two (2) goals that you would like to set with your child for this year.
    5. - To improve his academic skills
    6. - Interest in other subjects

    CONFORME
    o
    ✔ I certify that the information I have provided in this form is true and correct to the best of my knowledge. I
    am also allowing ESS to use the data in this inventory for routine interviews, mentoring/counseling,
    academic coordination and for research purposes while adhering to the Data Privacy Act of 2012.*

    Father’s Signature over Printed Name Guardian’s Signature over Printed Name

    Mother’s Signature over Printed Name Date

    *In lieu of your digital signature, checking the box and inputting your name in the spaces above signify that you agree to the
    aforementioned Conforme statement.

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