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Individual Inventory Record Form
2x2
05/28/2024
Plain White
Background Date
0024595
Student ID No. Course & Year: BSIT-2
I.Personal Information
Name: CABATCHETE MARIEL TUGAY Nickname: CHEN
Surname First Name Middle Name Suffix
Date of Birth: 12/14/2003 Gender: FEMALE Age: 20 Civil Status: SINGLE
Religion: IGLESIA FILIPINA INDEPENDIENTE
Place of Birth: POBLACION CAGDIANAO DINAGAT ISLANDS Ethnicity: FILIPINO
City Address: PUROK CADENA DE AMOR ESPINA STREET TAFT, SURIGAO CITY SURIGAO DEL NORTE
Street/Purok Barangay Municipality/City Province
Permanent Address: PUROK-4 SAN JUAN STREET POBLACION CAGDIANAO DINAGAT ISLANDS
Street/Purok Barangay Municipality/City Province
Landline No. N/A Mobile No. 09514055153 Email address: marielcabatchete51@gmail,com
II. Educational Background
High School General Average: 96
Level Name of School Address of School Period of Year Scholarship/
Attendance Graduated Academic Honors
Received
From To
Elementary CAGDIANAO DINAGAT ISLANDS
CAGDIANAO ELEMENTARY SCHOOL 2011 2016 2016 N/A
Secondary CAGDIANAO NATIONAL HIGH SCHOOL
CAGDIANAO DINAGAT ISLANDS
2017 2022 2022 WITH HONORS
Vocational
/
Trade
Course
College, if
any
III. Family Background
Name of Father: ROEL S. CABATCHETE Age: 53 indicate if deceased
Contact Number: 09630674452 Occupation: FARMER
Educational Attainment: HIGH SCHOOL LEVEL
Name of Employer: N/A
Address of Employer: N/A
Name of Mother: MARIVIC T. CABATCHETE Age: 52 indicate if deceased
Contact Number: 09126310363 Occupation: AGRICULTURIST
Educational Attainment: COLLEGE GRADUATE
Name of Employer: N/A
Address of Employer: N/A
Name of Guardian: Age: Relationship:
Contact Number: Occupation:
Educational Attainment:
Name of Employer:
Address of Employer:
Parents’ Marital Status: (Please indicate)
✔ Married and staying together Married but Separated
Not Married but Living Together Single Parent
Other’s (please specify) Widow
Parents Total Monthly Income: (Please Indicate)
Below ₱ 5, 000 ₱ 5,001- ₱ 10,0000
✔ ₱ 10,001- ₱ 15,000 ₱ 35,001- ₱ 40,000
₱ 15,001- ₱ 20,000 ₱ 40,001- ₱ 45,000
₱ 20,001- ₱ 25,000 ₱ 45,001- ₱ 50,000
₱ 25,001- ₱ 30,000 Above ₱ 50,001
₱ 30,001- ₱ 35,000 Others, please specify:
Children in the Family, include yourself
Name Age Civil Birth Order Educational School/Office
Status (eldest, middle child, Attainment
youngest, only child)
FRENCES RHEA T. CABATCHETE
21 SINGLE ELDEST COLLEGE STUDENT
NORTHEASTERN MINDANAO COLLEGES
MARIEL T. CABATCHETE 20 SINGLE MIDDLE CHILD COLLEGE STUDENT
NORTHEASTERN MINDANAO COLLEGES
JOHN ROI T. CABATCHETE 19 SINGLE YOUNGEST NORTHEASTERN MINDANAO COLLEGES
COLLEGE STUDENT
Number of Children, including yourself: 3
Number of Brothers: 1
Number of Sisters: 1
Number of brother/s or sister/s gainfully employed:
please indicate their ordinal position as children in the family (1st, 2nd 3rd,..10th child)
FRENCES RHEA CABATCHETE(1st), MARIEL CABATCHETE (2nd), JOHN ROI CABATCHETE(3rd)
Who finances your study? (Please indicate )
✔ Parent/s
Brother/Sister
Spouse
Scholarship
Relatives
Self-Supporting/Working Student
If you are a working student, please fill in the following:
Name of Employer: N/A
Address of Employer: N/A
Contact Number: N/A
IV. Health Information
A. Physical
Height (m): 152
Weight (kg): 45
Blood Type: N/A
Do you have problems with the following? Please Indicate
Vision:
Yes
✔ No
If yes, please specify:
Hearing:
Yes
✔ No
If yes, please specify:
Speech:
Yes
✔ No
If yes, please specify:
General Health & Other health issues:
Yes
✔ No
If yes, please specify:
Do you have any allergies?
Yes
✔ No
If yes, please specify:
B. Mental
Have you had consulted with a helping professional before? Please indicate the following.
Psychiatrist
Yes
✔ No
If yes, please answer the following:
When:
Purpose:
Psychologist
Yes
✔ No
If yes, please answer the following:
When:
Purpose:
Guidance Counselor:
Yes
✔ No
If yes, please answer the following:
When:
Purpose:
V. Physical & Social Environment
Do you have a conducive environment or place to study?
✔ Yes
No
Do you have your own room?
✔ Yes
No
If No, to whom?
Nature of Residence while attending school: Please indicate
Family Home
Relative’s house
Shares apartment with friends/relatives
Bed spacer
✔ Rented apartment
House of married brother/sister
Dormitory
If you are a bed spacer or renting an apartment, not living in a family home, please indicate the full address:
_____________________________________________________________________
PUROK CADENA DE AMOR ESPINA STREET
VI.Interests
1. Academics (Check the following that suits your interests.)
Research ✔ Computer and Technology
Student Government, Social Justice and Politics Community Extension Services
Journalism & Publication Others, please specify:
Speech and Debate
What is/are your favourite subjects?
COMPUTER HARDWARE SERVICING
What is /are the subject/s you like least?
MATHEMATICS, PROGRAMMING
2. Extra-Curricular ( Check the following that suits your interests.)
✔ Music ✔ Fashion
✔ Dance Photography
✔ Athletics & Sport Others, please specify:
Theatre &Drama
What are your hobbies? Write them in order in your preference.
1. COOKING
2. DANCING
3. LISTENING TO MUSIC
4. READING NOVELS
5. WATCHING KDRAMA
Your Ambition:
TO FINISH MY STUDY SO THAT I CAN LAND TO A DECENT WORK
Motto in Your Life:
"BE PROUD OF YOUR FAILURES, KEEP QUIET WHEN YOU SUCCEED"
(Student’s Signature)
