Know the Kids SDO Urdaneta City

INDIVIDUAL INQUIRY PROFILE OF STUDENTS

A. PERSONAL/BASIC INFORMATION
LRN: Name of Student
Gender: Birthdate Age
Address:
School Religion

B. Family Background
Father’s Name: Work:
Mother’s Name: Work:
Name of Guardian: Work:

Marital Status of Parents

_____Married/Living Together _____Unmarried/Live-in

_____Separated/Annulled _____Single Mom/Dad

Family’s monthly Gross

Income Bracket
_____Below 10,000 _____30,001-40,000
_____10,001-20,000 _____40,001-50,000
_____20,001-30,000 _____Above 50,000

Are you a member of 4Ps?

_____Yes _____No

Whom are you living with at present?

_____Both Parents _____Non-Relative
_____Guardian/Relative Other:_____________

Who is closer to you?

_____Mother _____Grandparents
_____Father Other:_____________

Whom did you grow up with?

_____Parent/s _____Relatives
_____Grandparents Other__________

C. SOCIO-EMOTIONAL ATTRIBUTES
Which of the following do you enjoy doing?
_____Singing _____Drawing/sketching
_____Dancing _____Cooking
_____Playing computer games _____Watching movies
_____Writing _____Texting and surfing the net
_____Reading _____Driving (motorcycle, bike, etc)
_____Cleaning the house _____Others _____________

What type of person are you?

_____Introvert/shy/loner _____Extrovert/active/outgoing
 Know the Kids SDO Urdaneta City

How would you describe your childhood days?

_____Happy/exciting _____sad/traumatic

Who do you enjoy/prefer as company?

_____Family _____Alone
_____Friends Other__________

Where do you enjoy staying?

_____Home Other_______________
_____School

What type of friends do you prefer?

_____Happy and loud _____Carefree
_____Quiet and Shy _____Studious
Other__________

Have you ever bullied?

_____Yes _____No

For what reason you were bullied?

______________________________________________________________________
______________

Do you have any record of bullying your peers or others?

_____Yes _____No

State the reason for bullying others.

______________________________________________________________________
______________

Are the criticism and suggestions of others important to you?

_____Yes _____No

How often do you pray?

_____Once a day _____Not at all
_____Twice a day Other_______________

D. NARRATIVE OF THE TEACHER IN-CHARGE ABOUT THE LEARNER’S

SIGNIFICANT INFO/CHARACTERISTICS
(Personal Aspect, Family Background and Learner’s Problem/concern
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Grade of Learner: 7-Amethyst

Updated by:
Mark Joseph N. Cometa
Class Adviser