Scribd
Upload
23 views1 page

Jprime Registration Form (LTMS)

This document is a registration form for various driving courses, including theoretical and practical driving options. It collects personal information from the applicant, Rogie Z. De Leon, and outlines policies and guidelines for students attending the courses. The applicant acknowledges understanding and agreeing to the terms stated in the document.

Uploaded by

akredit4
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
23 views1 page

Jprime Registration Form (LTMS)

This document is a registration form for various driving courses, including theoretical and practical driving options. It collects personal information from the applicant, Rogie Z. De Leon, and outlines policies and guidelines for students attending the courses. The applicant acknowledges understanding and agreeing to the terms stated in the document.

Uploaded by

akredit4
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

LTO ACCREDITED REGISTRATON FORM RECEIPT # _______________

COURSE APPLIED Please check the appropriate box :

COURSE
(FOR PRACTICAL DRIVING COURSE ONLY)
□THEORETICAL DRIVING COURSE (TDC)
MANUAL CLUTCH AUTOMATIC
□ FACE TO FACE □ ONLINE

□ PRACTICAL DRIVING COURSE (PDC) 8HRS. □ CAR □ _______ □ _______

□ CAR DRIVING LESSON 12HRS. (LICENSE □ MOTORCYCLE □ _______ □ _______


HOLDER)
□ TRICYCLE

LTMS CLIENT ID: 22-920213-4220642


__________________________________________________

PERSONAL INFORMATION
SURNAME FIRST NAME MIDDLE NAME
DE LEON ROGIE ZARAN
ADDRESS: STREET No. BARANGAY MUNICIPALITY/CITY PROVINCE. ZIP CODE

002 RIZAL STREET BRGY RIZAL TUY BATANGAS


BIRTH DATE (MM/DD/YY) AGE MOBILE/TELEPHONE NO.

02/13/1992 32 09652401963
E-MAIL ADDRESS : TAX IDENTIFCATION NUMBER:
[email protected] 413-135-902-000
GENDER : CIVIL STATUS NATIONALITY

□ M □ SINGLE □ DIVORCED FILIPINO


______________________
□ F □ MARRIED □ WIDOWED

PLEASE READ OUR POLICIES AND GUIDELINES!


POLICIES AND GUIDELINES

1. All students must wear proper clothing and footwear at all times. NO WEARING of shorts, sleeveless, high-heeled shoes, slippers and sandals
during practical training.

2. All students must arrive 15 minutes before the scheduled hands-on driving.
3. No smoking inside the training vehicle. Intoxicated students are not allowed to attend their driving lessons and lectures.
4. For cancellation of schedule, student should call at least 48 hours (2 days) prior to their scheduled driving lesson. Absent will be considered
counted.
5. Chaperons are not allowed inside the training vehicle and lecture room.
6. The company reserves the right to cancel anytime the hands-on driving if irresponsible behavior by the student driver puts the safety of the driving
instructor, training vehicle and other road users at risk.

7. Courses and fees are subject to change without prior notice.


8. Registration is non-transferable and non-refundable.

I hereby acknowledge that I have read, understand and agree to the terms of this document. I also hereby certify that all the information above is true
and accurate.

11/11/2024
Date of Registration _______________ Signature over Printed Name______________________
ROGIE Z. DE LEON

You might also like