Individual Inventory Form
Individual Inventory Form
Name:______________________________________________________Age:________________
Birthday: ___________________Birthplace: ___________________________________________
Address: _____________________________________________Cellphone no. ________________
Year & Section: ___________________________ Sex: ____________ No. of years in School:_____
1. Family:
Father ‘s name: _________________________________ Mother’s name: ____________________
Age: ________ Age: ___________
Occupation: __________________________________ Occupation: _________________________
3. Financial status
Total Annual Income ( single____ / Combined ______) - put a check (/) mark
- below 60,000.00 pesos a year ( ___)
- 60,000.00 to 100,000.00 pesos a year (___)
- 100,000.00 to 150,000.00 pesos a year (___)
- above 150,000.00 pesos (___)
4. Marital Status of Parents: kindly put a check (/) mark to what is applicable
Living together and here in the Philippines (_____)
Living together but one is working abroad (_____) who: _________________________________
Living together but both working abroad (____) where:__________________________________
Separated without each having a family (_____) who:___________________________________
Separated with other families (_____) who:___________________________________________
Living with other than parents (___) with whom: _______________________________________
5. Rank or order of birth: 1st (__), 2nd (____), middle (___), last (___), only (____)
6. No. of Brothers _______ Sisters _______
7. The person in the family you are close to and confident with:
1
father __, mother __, sister__ brother_
8. How would you describe you relationship with your (put a check (/) mark)
Father ------------ very close (___), just okay (___), better than not (____)
Mother----------- very close (___), just okay (___), better than not (____)
Sisters ------------very close (___), just okay (___), better than not (____)
Brothers ---------very close (___), just okay (___), better than not (____)
9. Personal
Favorite subject: ______________________________ most difficult subject:___________________
Inclinations (just put a check (/) mark: performing arts (___), sports (____), class leadership (___)
Interests: religious groupings (___), creative arts (____)
10. I want to be a…
_________________________ _____________________________ ___________________
First choice second choice third choice
11. Do you want to visit the guidance office for counseling? Yes (__)/ No (___)
12. Do you welcome home visitation? Yes (__)/ No (___)