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CONFIDENTIAL

Guidance Office Integrated School

AY _____________________

INDIVIDUAL INVENTORY RECORD

ISGO Form 2

We would like to thank you for choosing our school as your partner in your child’s
education. This will be your child’s initial inventory record with us. We would like to request you
to please honestly fill-out this form. The information and comments that you would share with
us could be utilized to assist your child and discover other factors that may contribute to the
formation of your child’s individuality.
Rest assured that all information gathered from this form shall be dealt with utmost
confidentiality.
Thank you very much.

Date: __________________________________ Grade Level: _________________

Name :______________________________________________________________________
Family First Middle Nickname

Age: _______ Date of Birth: _________________ Place of Birth: _______________________

Child’s Birth Order: _____ eldest _____ middle child _____ youngest _____ only child

Address:_____________________________________________________________________
____________________________________________________________________________

Contact numbers: Mobile ______________________ Land line _________________________

Check which of the following are applicable:

Parents living together ______ Father re-married ______ Widow ______

Parents separated ______ Mother re-married ______
Parent Working Abroad ______ Single Parent ______

Child is living with whom now? _____ parents _____ father only _____ mother only
_____ grandparents _____ others (specify) ____________________

Who else lives in the house?

_____ grandparents _____ uncle _____ auntie _____ others: __________________

CHILDREN IN THE FAMILY STARTING WITH THE ELDEST (include the applying child)

Name Age Birthday Civil School/Office

Status

1
 PARENTS’ RECORD
Information on FATHER Information on MOTHER
NAME
AGE
DATE OF BIRTH
PLACE OF BIRTH
CITIZENSHIP
RELIGION
EDUCATIONAL Level Degree Level
ATTAINMENT Degree
(Please check the level ( ) High School ________
and write the degree) ( ) High School _________
( ) Vocational _________
( ) Vocational ___________
( ) College _____________
( ) College ______________
( ) Graduate Studies _____
( ) Graduate Studies ______
SCHOOLS ATTENDED
PRESENT OCCUPATION
POSITION IN THE FIRM
NAME OF FIRM
ADDRESS OF FIRM
OFFICE TEL. NO.
OTHER CONTACT NOS.
(CELL PHONE, EMAIL
ADDRESS ETC.)
HOBBIES/INTERESTS
TRAITS/
CHARACTERISTICS
BIRTH ORDER ( ) eldest ( ) youngest ( ) eldest ( ) youngest
(PLS. CHECK) ( ) middle ( ) only child ( ) middle ( ) only child
FAMILY SIZE ( ) small (3-4 members) ( ) small (3-4 members)
(PLS. CHECK) ( ) medium (5-7 members) ( ) medium (5-7 members)
( ) large (8 and above) ( ) large (8 and above)

STUDENT’S HEALTH INFORMATION

Height: ________ Weight: ________

Has your child had any of the following illnesses? Pls. check those that have affected your child
for the past 5 years up to the present:

_____ asthma _____ hearing defects _____ nervousness

_____ convulsion or fits _____ heart diseases _____ pneumonia
_____ diabetes _____ hernia _____ smallpox
_____ epilepsy _____ influenza _____ stammering
_____ eye defects (pls. specify) _____ mumps _____ typhoid fever
_____ malaria _____ tuberculosis
_____ fainting spells _____ measles
_____ frequent headaches

Does your child have other special needs and concerns (e.g. ADD, ADHD, LD, etc.)? Please
specify.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Does your child have allergies (e.g. food, medicine etc.)? Please specify.
____________________________________________________________________________
____________________________________________________________________________

2
Was your child involved in any serious accident? If so, please specify.
____________________________________________________________________________
____________________________________________________________________________

Name of Family Doctor: ________________________________________________________

Telephone Numbers.: _________________________________________________________
Office Address: ____________________________________________________________
Preferred Hospital: ____________________________________________________________

EDUCATIONAL INFORMATION

Schools Attended: ____________________________________________________________

Best-liked Subjects: ___________________________________________________________
Least-liked Subjects: ___________________________________________________________
Grade Range/General Average on Report Card: _____________________________________
Awards Received: _____________________________________________________________
School Activities/Club: _________________________________________________________
Activities Outside the school: ____________________________________________________

PERSONALITY INFORMATION

Check those which you feel best describe your child’s general personality make-up:

_____ aggressive _____ honest _____ pessimistic

_____ anxious _____ independent _____ quick
_____ calm _____ irritable _____ quiet
_____ cheerful _____ jealous _____ sarcastic
_____ confident _____ lacks motivation _____ sensitive
_____ conscientious _____ lazy _____ shy
_____ courteous _____ lovable _____ smart
_____ depressed _____ moody _____ stubborn
_____ dull _____ neat _____ submissive
_____ easily confused _____ nervous _____ talented
_____ easily excited _____ optimistic _____ talkative
_____ easily tired _____ passive _____ thoughtful
_____ feels inferior _____ patient _____ withdrawn
_____ friendly _____ persevering

Others, please specify: ________________________________________________

SOCIAL RELATIONSHIPS

Please check any of the items that apply to your child.

At home:
_____ discusses problems with father _____ asserts himself/herself
_____ discusses problems with mother _____ demanding
_____ enjoys the company of siblings _____ goes only with familiar people
_____ enjoys family outings/affairs _____ prefers to be left alone
_____ friendly with household help _____ often fights with people in the house
_____ generous with his/her things _____ difficult to deal with
Others, please specify: __________________________________________________

In school:
_____ would rather be a follower _____ is looked as a leader
_____ friendly with the people in school _____ afraid of teachers/other students
_____ enjoys the company of classmates _____ would rather be alone
_____ interested in class activities _____ goes only with familiar people
_____ asserts himself / herself _____ always in trouble with classmates
Others, please specify: ___________________________________________________

3
 CAPACITY AND INTEREST

Please check any of the items that best describes your child:
_____ impatient _____ eager to do activities
_____ poor in comprehension _____ finishes tasks easily
_____ slow learner _____ learns quickly
_____ has short memory _____ orderly
_____ has academic difficulties _____ inquisitive
_____ creative _____ imaginative

Others, please specify:

____________________________________________________________________________

Please write some of your child’s interests/favorites in the following areas:

1. individual games____________________________________________________________
2. group games ______________________________________________________________
3. types of books _____________________________________________________________
4. kinds of food ______________________________________________________________
5. place he/she usually enjoys __________________________________________________

OTHER PERTINENT INFORMATION

Relate significant events / unforgettable experiences that happened in your child’s life.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

List down any difficulties, conflicts, obstacles or worries that you think disturbs your child.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

In what way could the guidance counselor help him/her at this time? Please write other
information, which you think is vital information to your child’s development.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

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List down three topics you are interested to learn from in a parenting seminar?
1. ______________________________________________________________________
2. ______________________________________________________________________
3. ______________________________________________________________________

Are you willing to be a speaker for any seminar? ______

What topics would you like to share?

1. ______________________________________________________________________
2. ______________________________________________________________________
3. ______________________________________________________________________

What would be the best day for you to attend the parenting seminars? ____________________

Father’s Signature ______________________ Mother’s Signature ___________________