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    Guidance Form Elem SAMPLE UPDATED

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    Jeffrey Marigmen
    This document contains a pupil's cumulative record and profile for Alinah D. Gonzales from Laur Central School in Nueva Ecija, Philippines. It includes personal information like name, birthdate, family details, health history, immunizations, scholastic achievement, and assessments of her behavior. Her academic performance has been good, averaging 88 in Grade 1. Her health examinations are also noted to be excellent. She lives with her well-to-do family and speaks Tagalog at home.

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

    Guidance Form Elem SAMPLE UPDATED

    Uploaded by

    Jeffrey Marigmen
    22 views4 pages
    This document contains a pupil's cumulative record and profile for Alinah D. Gonzales from Laur Central School in Nueva Ecija, Philippines. It includes personal information like name, birthdate, family details, health history, immunizations, scholastic achievement, and assessments of her behavior. Her academic performance has been good, averaging 88 in Grade 1. Her health examinations are also noted to be excellent. She lives with her well-to-do family and speaks Tagalog at home.

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    Guidance-Form-Elem-SAMPLE-UPDATED

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    This document contains a pupil's cumulative record and profile for Alinah D. Gonzales from Laur Central School in Nueva Ecija, Philippines. It includes personal information like name, birthdate, family details, health history, immunizations, scholastic achievement, and assessments of her behavior. Her academic performance has been good, averaging 88 in Grade 1. Her health examinations are also noted to be excellent. She lives with her well-to-do family and speaks Tagalog at home.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    22 views4 pages

    Guidance Form Elem SAMPLE UPDATED

    Uploaded by

    Jeffrey Marigmen
    This document contains a pupil's cumulative record and profile for Alinah D. Gonzales from Laur Central School in Nueva Ecija, Philippines. It includes personal information like name, birthdate, family details, health history, immunizations, scholastic achievement, and assessments of her behavior. Her academic performance has been good, averaging 88 in Grade 1. Her health examinations are also noted to be excellent. She lives with her well-to-do family and speaks Tagalog at home.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 4

    Guidance Form 1

    Republic of the Philippines


    Department of Education
    REGION III – CENTRAL LUZON
    SCHOOLS DIVISION OFFICE OF NUEVA ECIJA
    LAUR CENTRAL SCHOOL
    GEN. TINIO ST. LAUR, NUEVA ECIJA 3129

    LAUR CENTRAL SCHOOL


    _________________________________________
    (School)
    General Tinio Street,Brgy I,Laur,Nueva Ecija
    (Address of School)

    PUPIL’S CUMULATIVE RECORD AND PROFILE


    I – PERSONAL DATA

    Name: ALINAH D. GONZALES Age: 9


    Birth Date: January 03,2013 Place of Birth: Laur Nueva Ecija
    Address: 11 Roxas Street,Brgy. IV, Laur,Nueva Ecija Nationality: Filipino Religion: Roman Catholic

    II – FAMILY DATA
    A. Father / Guardian B. Mother
    Jose D. Gonzales Name Maria May D. Gonzales
    June 19,1975 Date of Birth May 20,1981
    Cabanatuan City Place of Birth Laur, Nueva Ecija
    College Graduate Educational Attainment College Graduate
    Driver Occupation Teacher
    Roman Catholic Religion Roman Catholic
    Date of Death (if deceased)
    Cause

    C. Children in the Family: Boys: _______0________ Girls: _____1_______ Total: _________1_______

    D. Home and Family Problems ( please Grade Level


    Remarks
    check) I II III IV V VI
    Broken Home
    Very Strict Parents
    Very Lax Parents
    Very Crowded Homes
    Indigent
    School Far from Home
    Others
    Teacher-Adviser’s Initial

    E. Economic Status: Well to do _____√_____ Average ___________ Poor ___________


    F. Language Used at Home: Bicol _________ Tagalog ___√________ English __________ Others
    ______________

    III – Health Status: Normal ________√______________________ Handicap ___________________________

    P - poor F – Fair G – Good Ex - Excellent


    Grade Level Remarks
    1. Health Examination ( please check) (P, F, G, Ex)
    I II III IV V VI
    Hearing √ √ √ Ex
    Vision √ √ √ Ex
    Speech √ √ √ Ex
    Skin and Scalp √ √ √ Ex
    General Health √ √ √ Ex
    Height √ √ √ Ex
    Weight √ √ √ Ex
    Blood Pressure √ √ √ Ex
    Eyes and Ears √ √ √ Ex
    Teeth and Gums √ √ √ Ex
    Throat and Tonsils √ √ √ Ex
    Respiratory System √ √ √ Ex
    Nutrition √ √ √ Ex
    Teacher-Adviser’s Initial

    2. Diseases / Sickness since Birth


    Typhoid Fever _____X_____________ Chicken Fox ______X______________ Dysentery _________X_________
    Whooping Cough __________________ Influenza ____________X________ Mumps __________X________
    Asthma___________X_______ Measles ____X________________

    Action Taken _______________________________________


    Examine by: _______________________________________
    3. Immunization and Immunity Test
    Kind Date Given Result
    NONE

    4. Operation Undergone _______________________NONE___________________________________________________


    5. Physical Defects _____NONE____________________________________________________________________

    IV SCHOLASTIC ACHIEVEMENT
    Grade Subjects Done General Teacher-
    A. School Attended Level Subjects Done Well Poorly Average Adviser’s
    Initial
    Laur Central School I 88

    Laur Central School II

    Laur Central School III

    Laur Central School IV

    V
    VI

    B. Standard Test Record Grade Date Scores Interpretation


    Knox Tube Test
    Printer Personality Inventory
    Philippine Personality
    Otis Lannon Mental Ability
    Others

    V APPRAISAL OF PUPIL BEHAVIOR


    O VS S NS NI ( to be rated after the semester)
    Grade Level
    A. Personal Qualities Remarks
    I II III IV V VI
    1. Honesty √ √ √ √ VS
    2. Courtesy √ √ √ √ VS
    3. Helpfulness and Cooperation √ √ √ √ VS
    4. Resourcefulness and Creativity √ √ √ √ VS
    5. Consideration for others √ √ √ √ VS
    6. Sportsmanship √ √ √ √ VS
    7. Obedience √ √ √ √ VS
    8. Self – Reliance √ √ √ √ VS
    9. Industry √ √ √ √ VS
    10. Cleanliness and Orderliness √ √ √ √ VS
    11. Promptness and Punctuality √ √ √ √ VS
    12. Sense of Responsibility √ √ √ √ VS
    13. Love of God √ √ √ √ VS
    14. Patriotism / Love of Country √ √ √ √ VS
    Teacher-Adviser’s Initial

    Grade Level
    B. School Problems Remarks
    I II III IV V VI
    1. Underachiever
    2. Slow Learner
    3. No Interest
    4. Potential Drop-outs
    5. Frequently Absent
    6. Frequently Late
    7. Others
    Teacher-Adviser’s Initial

    C. Home Visits
    E – Excellent G – Good F – Fair N – Need Improvement
    Grade Waste Home
    Date of Visit Dwelling Facilities Surroundings Recommendation Teacher
    Level Disposal Project
    I
    II
    III
    IV
    V
    VI
    D. Significant Notes on Personal and Social Traits
    Teacher-
    Grade Teacher Comments Adviser’s
    Initial
    I LUZ G.CARDENAS
    II DOMINICIANA P. OBLIGADO
    III MARITA N. DELA CRUZ
    IV YOLANDA PANGILINAN
    V

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