Iir Revised Sy 2020 2021
Iir Revised Sy 2020 2021
Iir Revised Sy 2020 2021
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.
Strengths
Singing, Playing musical instruments, Watching movies and series, Listening to music, Reading books,
Social Media, Hanging out with friends, travelling
Interests
She plays the Piano and the Ukelele, She likes to watch any movie genre, she mostly listens to pop
songs, her favorte books are the Harry Potter series, her favorite social medias are Instagram and
Preferences Tiktok.
N/A
Behavior
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 be a Merit Card Holder or Medalist
6. - To finish and graduate Junior High School
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
*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.