Republic of the Philippines

Department of Education
Region IV-A (CALABARZON)
CITY SCHOOLS DIVISION OF BACOOR
Bacoor City, Cavite

INDIVIDUAL INVENTORY RECORD FORM

I. Pupil’s Personal Data

Liam Eric S. Desamito

Name: ________________________________________________Grade Daffodil
& Section: K- ________________ Nickname: Liam
__________
1. Place of Birth: Bacoor, Cavite
____________________________________________________ 14 April 2016
Date of Birth: ________________
2. Nerrie Jane Santos
Guardian: _________________________ Filipino
Nationality: ________________ Religion: ________________
3. Mother Address:______________________________________________
Relationship:___________ Blk 13 Lot 8 Telesfora St. Casimiro Baytown Village, Habay 1, (046)-431-1557
Tel.No: __________________
Bacoor, Cavite
4.
Sept. 13, 2021 K- Daffodil June 2022
5. Date of Admission: ________________ Gr.&Sec.: ________________ Date Presented: ________________

II. Family Data

1. Father’s Name: Derick T. Desamito 16 March 1977
Date of Birth: ______________________________
Place of Birth: Lamut, Ifugao Educational Attainment: BS Criminology _
Nationality: Filipino Religion: Protestant Military
Occupation: ____________________
2. Mother’s Name: Nerrie Jane Santos 11 January 1977
Date of Birth: _________________________
Bacoor, Cavite BS Computer Science
Place of Birth: ____________________________________ Educational Attainment: _______________________
Filipino
Nationality:________________________ Roman Catholic
Religion: ____________________ Government Employee
Occupation: ________________________
3. Number of Children: Boys : 1 Girls : 1 2
Total No.of Children:_________
4. Single
Civil Status: _____________________ Minimum wage
Family Economic Status: ___________________________________
5. Filipino and English
Language or Dialect use at home: _____________________________
6. Address: _________________________________________________________
Blk 13 Lot 8 Telesfora St. Casimiro Baytown Ville., Habay 1, Bacoor, Cavite House Owned: Rented Total_________

III. Educational Data

Name of School Attended Grade & Section Date Attended General Average
Habay Elementary School Kinder-Daffodil S.Y 2021-2022

N/
2. Failed or Dropped in any grade_________What N/ N/
Grade? _____________Year____________Caused N/
by_______________
3. Special ability or talents in:____________________________________________________________________________
4. Honors Earned in School:_____________________________________________________________________________

IV. Health and Physical Data

Height I II III IV V VI Weight I II III IV Hair
Physique
Vision

N/
2. Hearing:___________Speech______________Teeth________________Phy. Handicapped________Caused N/
by;_________

3. Disease or Illness experienced_______________________________________________________________.

V. Emotional Data
√
1. The Child is affectionate___________ Shy___________fearful____________Aggressive__________
2. He is hostile ___________ restless ______________ overactive_______________
3. He is exhibits temper ______________
√ tantrums______________ sullenness _____________
4. He is more attached to his/ her mother ________________
√ grandmother ______________________
 VI. Social Data Behavior

1. √
The Child is cooperative ____________ √
courteous __________ √
dependable _______________
2. He is industrious ___________________
√ √
conscientious _______________
3. He is diligent _____________ √
√ trustworthy ____________________
4. He is sociable ____________
√ obedient ___________√ witty ____________ √
5. He is overentical of others _________________ imprudent___________
6. His constant companion at home mother, sibling, grandmother at school_________________
7. √
He is fond of playing alone _____________________with many children _________________
√
with others _________with sisters_________ √
with opposite sex ___________________
8. Child’s membership in any community organization ________________________________________
9. Child’s attitude towards his/her parents ____loving_____________ brothers ______________________
Sister __ sweet ____________ teachers respectful classmates friendly__________
10. Child’s home duties: sweeping, taking care of her sister and make beds

VII. Avocational and Vocational Data

1. Child’s Hobbies: Watching Youtube, Tiktok, Singing and Dancing

2. Materials read: comics ___________ magazines ____________ newspaper _______________
3. Child’s vocational experienced amount earned easily : ____________________
4. Child’s ambitions are to become a police or fireman.
5. Mother’s ambition for the child is to support what her daughter likes to be.
6. Father’s ambition for the child is to become a doctor .

PART VIII DON’T ANSWER.

VIII. Child’s Present Major Interest (Write the no.priority)

Listening to I II III IV V VI Telling stories

I II III IV V VI radio
Building or making
Watching things
television
Drawing or coloring
Looking at books
Pictures
or magazines
Listening to music or
Collecting things
playing by himself
Taking care of
pets Playing with others

On the basis of you observation, check any of the following characteristics, which best described the child.

I II III IV V VI Talks constantly Inquistic

Active Good humor
I II III IV V VI
IV. upset
Easily Healthy
Seldom complete Patient
task Not much help at home
Learns easily Upset by criticism
Enjoy his meal