Republic of the Philippines

Department of Education

PHOTO
LEARNER PROFILE

Name:____________________________________________________ Date of Birth ____________ Gender

_______
Home Address: _____________________________________________
Distance of Home to School (km)
Name of Mother: ________________________________________ Occupation:
______________________________
Name of Father: _________________________________________ Occupation:
______________________________
Annual Family Income: ______________________ Number of Siblings : M____ F_______ Sibling
Position:__________
Risk Factors Manifested:
___________________________________________________________________________
Intelligences Possessed:_____________________________________________ ______________________
Personality:__________________________________________________________ Remarks:
___________________
Interests:_______________________________________________________________________________________
Reaiding Level: ________________________________________ Numeracy Level:
____________________________
Neighbor SchoolMates:
_____________________________________________________________________________
________________________________________________________________________________________________
Person to Contact in case of Emergency: ______________________________________ Contact
No.:______________
Map of Residence (from School to Home):