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Republic of the Philippines
NATIONAL COMMISSION OF SENIOR CITIZENS
Republic of the Philippines
Office of the President of the Republic of the Philippines
NATIONAL COMMISSION OF SENIOR CITIZENS
9200-000000000
ONLINE SENIOR CITIZEN DATA FORM
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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
1. Name - Enter your name correctly
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
35.e Social / Emotional
Health Problems / Ailments
35.c Visual Concern
35.d Aural/Hearing Condition
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 government ID and attach it here. 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.
IMAGE OF THE ID CARD ATTACHEMENT IS NOW REQUIRED.
ATTACH YOUR LATEST PHOTO
To attach your captured photo, take your actual picture or selfie using your mobile phone and click on the Upload button below and locate the photo file from your device to upload it here. We need a close-up image of your face, so please take a 2x2 size photo capture only.
Please take a selfie of your face. Do not attach a whole-body picture or your younger-year photo, we need the actual senior photo of your face only.
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.
Warning : Make sure to remember and take note of your PKN before submitting.
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
WARNING:
CHECK ALL YOUR ENTRIES BEFORE YOU SUBMIT THEM. EDITING THE DATA IS COMPLICATED AS IT DEMANDS RIGOROUS TIME TO CORRECT.
I-check muna lahat ng pangalan, address, birthday, at iba pang inpormasyon kung tama bago mag submit.
Hindi na po mababago ang record kung naisubmit na.
Kung may mali sa naisubmit mo, kailangan sumulat sa scdf.ncsc@gmail.com at magbigay ng pagkakakilanlan bago ma update ang iyong record. Mahirap gawin ito kaya iwasan ang pagsubmit ng mali mali!
WARNING TO ALL ENCODERS!
Make sure to encode all the information correctly. Any mistake may invalidate the registration of the data subject.
Are you sure that the record is correct and ready for submission?
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Due to a high volume of submissions, the registration processing time is longer than usual, or may experience intermittent connection issues. Just keep on retrying until the processing pushes through. We appreciate your patience.
Congratulations!
You have successfully submitted your application for registration.
Name
Registration Reference Number (RRN)
0
Please take note and keep your registration reference number or RRN as shown above.
You will use this number to check and verify the status of your registration later.
It would be best if you can take a picture of it for your safekeeping.
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