Student No.

: UG201800696

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INDIVIDUAL INVENTORY RECORD FORM

Date:SEPTEMBER 26, 2019

Please PRINT clearly

My Philosophy in life: Do not be anxious about anything because God is always up to something
I. PERSONAL INFORMATION

Name: AMBAT ANNA NOLEEN SARMIENTO Sex:FEMALE Age: 20

(Surname) (First Name) (Middle Name)
E-mail:__ ambat.ans@pnu.edu.ph
Course: Batsilyer sa Edukasyong Filipino Year and Section: II-5 Civil Status SINGLE
City Address: 1150 Brgy. 659 NATIVIDAD A. LOPEZ ST. ERMITA, MANILA Cellphone 0945-721-8295 Tel.No.: N/A
Provincial Address: 087 J. AMBAGAN ST. BRGY 3 AMADEO, CAVITE Tel.No.: (046) 483-36-72
Date of Birt APRIL 14, 1999 Place of Birth: IMUS, CAVITE Religion: CATHOLIC
If working, please indicate the name and address of Company: N/A

II. HOME AND FAMILY

Name of Father: NOLIE P. AMBAT Age: 48 Living: YES Deceased:

Educational Attainment: COLLEGE GRADUATE Occupation: OFW- SUPERVISOR
Name of Company: NIGERIAN CARTON Address of Company: NIGERIA, AFRICA

Name of Mother: ANNA LOURDES A. SARMIENTO Age: 49 Living: YES Deceased:

Educational Attainment: COLLEGE GRADUATE Occupation: HIGH SCHOOL TEACHER
Name of Company: TRECE MARTIRES CITY NATIONAL HIGH SCHOOL Address of Company: TRECE MARTIRES CITY

Name of Guardian: ANNA LOURDES A. SARMIENTO Age: 49 Living: YES Deceased:

Educational Attainment: COLLEGE GRADUATE Occupation: HIGH SCHOOL TEACHER
Name of Company: TRECE MARTIRES CITY NATIONAL HIGH SCHOOL Address of Company: TRECE MARTIRES CITY

Parent's Marital Relationship (please Check)

[ ] Married and staying together [ / ] Not married but staying together
[ ] Married but separated [ ] Other's (please specify):

Socio-Economic Status of the Family (please check)

[ ] P 5,000-Below [ ] P 15,001-P 20,000 [ / ] P 30,001-P 35,000 [ ] P 45,001-P 50,000
[ ] P 5,000-P 10,000 [ ] P 20,001-P 25,000 [ ] P 35,001-P 40,000 [ ] P 50,001-Above
[ ] P 10,001-P 15,000 [ ] P 25,001-P 30,000 [ ] P 40,001-P 45,000

Number of Children in the Family including yourself: 2 No. of Boys 1 No. of Girls 1
Number of brothers/sisters gainfully employed: N/A No. of Brother/s: No. of Sister/s:
Ordinal position in the Family (1st child, 2nd Child, only child): 1st Child
Do you have a quiet place to study? (please check) [ / ] Yes [ ] No
Do you share your room with anyone? (please check) [ / ] Yes [ ] No
If yes with whom? PARENTS

Nature of Residence while attending school: (please check)

[ ] Family Home [ ] Bed Spacer
[ ] Relative's House [ ] Rented Apartment
[ ] with Married Brother/Sister [ ] shares Apartment with friends
[ / ] Dormitory [ ] other's (please specify)_____________________________________

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OLIC

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III. HEALTH

Weight: 55 kgs. Height: 157 cm Complexion: KAYUMANGGI

Do you have problems with (please check)

YES NO If YES, please specify
Your Vision [ /] [ ] NEAR-SIGHTEDNESS
Your Hearing [ ] [/]
Your Speech [ ] [/]
Your General Health [ ] [/]

IV. EDUCATIONAL BACKGROUND

PUBLIC/ DATES OF
LEVEL NAME OF SCHOOL LOCATION/ADDRESS
PRIVATE ATTENDANCE

Nursery SUNSTAR ACADEMY BRGY. 2 AMADEO CAVITE PRIVATE 2003

Preparatory SUNSTAR ACADEMY BRGY. 2 AMADEO CAVITE PRIVATE 2005
Elementary AMADEO ELEMENTARY SCHOOL BRGY. 2 AMADEO CAVITE PUBLIC 2006-2012
High School INFANT JESUS ACADEMY OF SILANG, INC. J.P RIZAL ST. SILANG, CAVITE PRIVATE 2012-2016
Senior High School INFANT JESUS ACADEMY OF SILANG, INC. J.P RIZAL ST. SILANG, CAVITE PRIVATE 2016-2018
Student's NCAE Result: N/A
Nature of Schooling: [ / ] Continuous [ ] Interrupted, Why?______________________________________

V. HOBBIES AND INTERESTS

What are your hobbies? Write them in the order of your preference:
1 PAGSUSULAT NG TULA 3 PANUNUOD NG MGA SPOKEN WORD POETRY
2 PANUNUOD NG MGA PELIKULA AT KOREAN DRAMAS 4 PAGLILIBOT KUNG SAAN-SAAN

Which of the following organizations are you a member of? (please check)
[ ] Athletics [ ] Glee Club
[ ] Drama Club [ ] Chess Club
[ ] Religious Organization [ / ] Others, please specify: KAPISANAN NG DIWA AT PANITIK (KADIPAN)

What is/are your favorite subject/s (in senior high)? MALIKHAING PAGSUSULAT
What is/are the subject/s you like least (in senior high)? WORLD RELIGION

VI. REASON/S FOR ENROLLING IN PNU

1 KILALA BILANG "NATIONAL CENTER FOR TEACHER EDUCATION"
2 NOONPAMAN AY PANGARAP KO NA MAG-ARAL SA PNU

VII. REASON/S FOR TAKING TEACHER EDUCATION PROGRAM

1 BATA PA LAMANG AY PANGARAP KO NA MAGING ISANG GURO
2 LUMAKI AKO SA PAMILYA NA PURO GURO ANG PROPESYON

VIII. SKILLS AND TALENTS

Which of the following skills and talents do you have? (please check)
[ ] Singing [ / ] Literary Works
[ ] Dancing [ ] Declamation/Oration
[ ] Driving [ ] Painting/Drawing/Sketching
[ / ] Photography [ ] Cooking
[ ] Web Development [ ] Others, please specify:

IX. WHAT ARE THE THINGS YOU VALUE AND WHY?

Sa aking buhay, may mga bagay akong pinapahalagahan. Una, ang aking pamilya lagi't lagi para sa kanila
ang lahat ng aking pagsisikap na makapagtapos. Sila ang aking lakas para makapagpatuloy sa buhay.
Pangalawa, ay ang aking rosaryo na hindi ko kinakalimutan na dalhin o suotin araw-araw. Dahil ito ay
sumisimbolo sa aking malalim na relasyon sa ating Diyos. Ito ay nagpapaalala sa akin na palagi Niya akong
ginagabayan araw-araw. Panghuli ay ang aking "laptop". Ang laking tulong ng aking laptop sa aking pag-
aaral, mas napapadali nito ang paggawa ko ng aking mga takdang aralin. At ito ay regalo sa akin ng aking
tatay na panigurado ay pinaghirapan niyang maigi bago ito mabili.

(Student's Signature)
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