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` STUDENT PROFILE 1

NAME : _______________________________________
LAST FIRST MIDDLE
SECTION : ___________________ DATE OF BIRTH :______________

AGE : _____________ GENDER :_________ RELIGION :____________

HOME ADDRESS : ___________________________________________


STUDENT CELL PHONE NUMBER :_____________________

NAME OF FATHER:____________________________AGE:____OCCUPATION : __________


CONTACT NUMBER :_______________________
NAME OF MOTHER:___________________________AGE:____OCCUPATION :___________
CONTACT NUMBER :____________________

QUESTIONS :

1 How peaceful is the environment at home while learning ?______________________________


____________________________________________________________________________
____________________________________________________________________________

2. Do you have any


2.1 special needs?
________________________________________________________________
_____________________________________________________________________________
2.2 health concerns or disabilities?
__________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

2.3 difficulties ? internet connectivity , software (please specify or give enough details )
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
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TALENT AND SKILLS

____________________________________________________________________________________
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