The following data to be collected will be forwarded to the Guidance Center.
All information will be treated with utmost confidentiality.
These will be used to create programs to help you better.
Name: _____________________________________________________
Section: ___________________
Kindly check ALL that applies to you. (Lagyan ng tsek LAHAT ng pumapatungkol sa iyo.)
BE HONEST.
I am…
Follow-up
an irregular student
transferred-in 1st Semester
nd
Saang paaralan galing:
transferred-in 2 Semester
Saang paaralan galing:
balik-aral (dating huminto sa pag-aaral)
Taon na huling pumasok:
pregnant
Pang-ilang anak:
a parent (has son/daughter)
Ilan na ang anak:
a working student
Saan nagtatrabaho:
a PWD (physically handicapped)
Anong kapansanan:
with health condition
Anong sakit:
mentally handicapped
Anong kapansanan:
an indigent
distressed and/or displaced learner
(transferred due to major disaster)
low resourced students
Saang lugar: ___________________________________________
Anong disaster:
Average monthly income ng buong pamilya:
(limited access to external resources: low income)
both parents are unemployed
abandoned and neglected children
(no parent / guardian)
Saan nakatira: __________________________________________
Sino ang sumusuporta sa pag-aaral:
street children
child of former rebels / prisoner
in conflict with the law
(has pending case in court)
living in conflict areas
Saang lugar:
from geographically isolated areas
Saang lugar:
living outside Cuenca
Saan nakatira:
child of an OFW
Tatay, saang bansa: ______________________________________
Nanay, saang bansa:
living with solo parent/separated
living with guardian
20 years old and above
living with HIV/ children of people living with HIV
Thank you!
Pangalan: ______________________________________________
Kaanu-ano: