Please fill up completely and correctly the required information before each item below. For items that are not associated to you, leave it blank. Required items are also marked with an asterisk (*) so please fill it up correctly. Your honest response will help the National Commission of Senior Citizens (NCSC) come up with a good information system of the senior citizens in the country as the basis of designing its programs and activities that will help improve the lives of Filipino older persons.
* Items with an asterisk (*) are required.
I. IDENTIFYING INFORMATION
NOTICE: Do not include special characters like this *(!@$%^&, etc. in your name entry. This will create an issue in the record during verification. Extensions like SR. or JR., etc. must be entered separately by checking on the box provided below.
1. Name - Enter your name correctly
How do you type Ñ in your phone or laptop? Click here!
Using your phone
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Hold the N/n key and the letter n with different accent marks will pop up.
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Slide to choose Ñ/ñ.
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If Ñ/ñ doesn’t appear when you long press the N/n key, check your keyboard settings. If the language of your keyboard is set to English, enable Filipino or Spanish too. This should make Ñ/ñ available as an option when you hold the N/n key.
Using your Computer or Laptop
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If your keyboard has a numeric keypad, you can type Ñ/ñ by following these steps:
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Enable the numeric keypad by turning on the Num lock key.
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Hold the Alt key then type 164 on the numeric keypad to create a lowercase ñ. For the uppercase Ñ, hold the Alt key then type 165.
Note that this would only work if your computer / laptop has a numeric keypad located on the right side of the keyboard.
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To easily remember, here are the keyboard shortcuts:
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ñ - Alt + 164
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Ñ - Alt + 165
2. Address - Select region first, and then province, then city, and finally your barangay
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3. Birth Date - Indicate your birth date correctly
Click here to check for your age.
II. FAMILY COMPOSITION
21. Name of your spouse
22. Name of your father
23. Name of your mother
24. Name of your child(ren) - If applicable, enumerate the first five and arrange them from oldest to youngest
24.a Other Dependents - If applicable, specify your dependents below. Dependents are those living with you
III. DEPENDENCY PROFILE
25. Living Condition (Check all applicable)
26. Living Condition (Check all applicable)
IV. EDUCATION / HR PROFILE
27. Highest Educational
Attainment
28. Specialization / Technical Skills (Check all applicable)
29. Shared Skills (Community Service)
30. Involvement in Community Activities (Check all applicable)
V. ECONOMIC PROFILE
31. Source of Income and Assistance (Check all applicable)
32.A Assets: Real and Immovable Properties (Check all applicable)
32.B Assets: Personal and Movable Properties
33. Monthly Income (in Philippine Peso)
This item is optional
34. Problems / Needs Commonly Encountered (Check all applicable)
VI. HEALTH PROFILE
35.a Medical Concern
35.b Dental Concern
Health Problems / Ailments
35.c Visual Concern
35.d Aural/Hearing Condition
35.e Social / Emotional
35.f Area of Difficulty
36. List of Medicines for Maintenance (Type all your maintenance medicines. Example : Amlodiphne 10mg, Losartan 50mg, etc.)
37. Do you have a scheduled medical/physical check-up?
37.A If Yes, when is it done?
O S C A I D A N D P H O T O A T T A C H M E N T
ATTACH IMAGE OF YOUR OSCA ID*
* Office of Senior Citizens Affairs (OSCA) ID is required

Please take an image or picture of your OSCA-ID or any valid government ID.
To attach the image file, take a picture of your OSCA ID and then click on the "Upload your ID" button to locate the image file from your local drive or mobile. If you don't have an OSCA ID then you can attach any valid ID you have in your possesion.
* This attachment item is required. Please make sure that the name of the registrant matches with the name indicated in the attached ID.
WARNING: DO NOT ATTACH AN INVALID ID AS IT MAY ALSO INVALIDATE THE REGISTRATION.
ATTACH YOUR LATEST PHOTO

Take a selfie or an actual picture of your face using a camera or your mobile phone. After the photo has been taken, click on the "Upload" button and locate the image from your local storage or device to attach. We need a close-up image of your face, so please take an approximately 2x2 size photo capture.
Do not attach a whole-body picture or your younger-year photo. We only need the actual photo of the face.
P A S S K E Y N U M B E R
Create your own Pass Key Number * (PKN)
Please create your own PKN for your registration below. You will need this to access and verify your record later. The maximum combination for the nominated PKN is four (4) digits only. Make sure to remember and take note of your PKN prior to the submission of the form.
Warning to encoders, do not use the same PKN for all your encoding works.
Click here to show your PKN
A F F I X Y O U R S I G N A T U R E
Please affix your signature
Please sign in the space provided below. If you are using a desktop computer or a laptop, use your mouse to sign by pointing to the space below, left-click and hold, and draw your signature. If you are using a mobile device, use your fingertip to draw your signature. You can change your signature by clicking on the "Clear" action button in the right-bottom corner of the space provided and drawing your signature again. You can proceed after you become satisfied with your signature.
(If the applicant is unable to sign, just proceed and leave the signature blank)
CONFIRMATION TO ALLOW THE STORAGE AND USE OF MY PERSONAL DATA
This is to certify that
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CHECK YOUR ENTRIES!
Scroll down below and check your entries before you submit.

Complete Name
NAME
Address
Address
Residence
Date of Birth
Birthday
Sex at Birth
Gender
Marital Status
Marital Status
Contact No.
Contact No.
Email Address
Blood Type
Blood Type
PKN
My Signature

