Date: ______________ No: ___________

COURSE: Automotive servicing SCHEDULE: 6 Months ( Saturday Session )

I. STUDENT’S FULL NAME:
Ronquillo Mark Angelo
_________________ ___________________ Dumanhog
__________________ _________ ____________
(LAST NAME/Apelyido) (FIRST NAME/Unang Pangalan) (MIDDLE NAME/Gitnang Pangalan) (MIDDLE INITIAL) (EXTENTION NAME (E.G. JR., I, II)

II. Manila
______________________ ______________________________ Hospital Ng Maynila
____________________________
(BIRTHPLACE REGION) (BIRTHPLACE PROVINCE) (BIRTHPLACE CITY/MUNICIPALITY)
06/10/1991 32 ✔
III. DATE OF BIRTH (MM/DD/YYYY):___________________________ IV. AGE: V. GENDER: (MALE) (FEMALE)
Markchaves49
VI. EMAIL:_________________________________@gmail.com 09103811867
CELLPHONE #/TEL#: ________________________
Blk 5 Lot 2 Tanguile St, Manila Doctors Village Almanza Uno Las Piñas City
VII-A. COMPLETE PERMANENT ADDRESS: ______________________________________________________________
VII-B. TYPE OF RESIDENCY: OWNED RENTED AMORTIZED ✔ SHARED W/ OTHER FAMILY/RELATIVES OTHERS (please specify)______________
Maricar Arcilla
VIII. IN CASE OF EMERGENCY (Parents/Guardian): _____________________________ 09319301791
(CP# /TEL.#):_______________________
Blk 5 Lot 2 Tanguile St, Manila Doctors Village Almanza Uno Las Piñas City
(COMPLETE PERMANENT ADDRESS): ________________________________________________________________________________________
IX. CIVIL STATUS: (SINGLE /MARRIED/ SEPARATED/DIVORCED/ANNULED/COMMON LAW or LIVE IN/WIDOW/ER): __________________________
Live in
Vocational Graduate
X. HIGHEST EDUCATIONAL ATTAINMENT: (Before the training) __________________________________________
XI. EMPLOYMENT TYPE: (PLEASE CHECK THE ANSWER) EMPLOYED (MAY TRABAHO) ✔ UNEMPLOYED (WALANG TRABAHO)
XII. EMPLOYMENT STATUS: (PLEASE CHECK THE ANSWER) J.O. PROBATIONARY CASUAL CONTRACTUAL REGULAR ✔

XIII. TOTAL GROSS MONTHLY Income (Combined income of all members of the family per month)
Php 1,000-5,000 Php 5,001-10,000 ✔ Php 10,001-20,000 Php 20,001-30,000 Php 30,001-above
XIV. CLIENT TYPE: (Before the training)
❑ Out of School Youth ❑ Student ❑ ✔
TESDA Alumni ❑ Agrarian Reform Beneficiary ❑ Rebel Returnees/Decommissioned Combatants ❑ Farmers & Fishermen

❑ Displaced Workers ❑ Solo Parent ❑ 4Ps Beneficiary ❑ Wounded-in-Action AFP & PNP Personnel ❑ Victim of Natural Disasters & Calamities ❑ OTHERS:

❑ TVET Trainers ❑ MILF Beneficiary ❑ Balik Probinsya

❑ Family Members of AFP & PNP Wounded-in-Action ❑ Indigenous People & Cultural Communities
(Please Specify)

❑ Inmates & Detainees ❑ OFW Dependent ❑ Industry Workers

❑ Family Members of AFP & PNP Killed-in-Action ❑ Returning/Repatriated OFWs

XV-A Type of Disability (for Persons with Disability Only): (PLEASE CHECK THE ANSWER) XV-B Cause of Disability
❑ Mental/Intellectual ❑ Visual Disability ❑ Orthopedic (Musculoskeletal) Disability ❑ Congenital/Inborn

❑ Hearing Disability ❑ Speech Impairment ❑ Multiple Disabilities, specify ❑ Illness

❑ Psychosocial ❑ Disability Due to Chronic Illness ❑ Learning Disability ❑ Injury

XVI. Reason for taking Course at LPCMTC: (PLEASE CHECK THE ANSWER)

❑ Learning opportunity since elementary or high school ❑ Choice after High School due to lack of funds for college. ❑
✔
Apply for another course for additional knowledge.
❑ Supplemental knowledge after Senior High School. ❑ Choice while waiting for funds for college. ❑ Others (Please specify):_________________________________

XVII. Plans after graduation: (PLEASE CHECK THE ANSWER)

❑✔

Apply for local employment ❑ Set up my own business ❑ Others (Please specify): ______________________

❑ Apply for employment abroad ❑

✔

Apply for NC2 as an additional credential _________________________________________

XVIII. Privacy Disclaimer

I hereby attest that I have read and understood the Privacy Notice of LPCMTC & TESDA through its website (https://www.tesda.gov.ph) and thereby giving my
consent in the processing of my personal information indicated in this Learner Profile. The processing includes scholarship, employment, survey and all other
TESDA program that may be beneficial to my qualification. (PLEASE CHECK THE ANSWER). AGREE ✔ DISAGREE
I M P O R T A N T R E M I N D E R S:
•AS STUDENT, I WILL ABIDE THE LAS PIÑAS CITY MANPOWER TRAINING CENTER POLICY*EMPLOYMENT CERTIFICATE IS MANDATORY REQUIREMENT OF TESDA (REGISTERED PROGRAM) FOR THE COMPLETION OF THE WHOLE
COURSE. THE LPCMTC IS NOT LIABLE FOR ANY UNTOWARDS INCIDENTS THAT MAY OCCUR IN ANY ENTIRE TRAINING HERE AT LPCMTC.
•FAILURE TO ATTEND THE *ORIENTATION *FIRST DAY OF CLASS *FAILURE TO RESPOND WITH INQUIRY VIA EMAIL, CALL & TEXT, FOR VERIFICATION YOU ARE ALREADY CO NSIDERED DROP-OUT. NO ADMISSION SLIP, NO ENTRY.

Mark Angelo D. Ronquillo

Conforme: ___________________________________
Student’s Signature over Printed Name
(Actual or Digital signature is required to be validated)

ADMISSION SLIP No: _____________

STUDENT’S COURSE: SCHEDULE:

FULL NAME: Mark Angelo D. Ronquillo Automotive Servicing 6 Months ( Saturday Session )

DATE ENROLLED:_____________________
SHEILA N. BACHICHA MELODY T. BASAN
Enrollment Officer MDO I / Registrar / Online T2MIS Officer CLASSES START:______________________
T2MIS Officer
I M P O R T A N T R E M I N D E R S:
•AS STUDENT, I WILL ABIDE THE LAS PIÑAS CITY MANPOWER TRAINING CENTER POLICY*EMPLOYMENT CERTIFICATE IS MANDATORY REQUIREMENT OF TESDA (REGISTERED PROGRAM) FOR THE COMPLETION OF THE WHOLE
COURSE. THE LPCMTC IS NOT LIABLE FOR ANY UNTOWARDS INCIDENTS THAT MAY OCCUR IN ANY ENTIRE TRAINING HERE AT LPCMTC.
•FAILURE TO ATTEND THE *ORIENTATION *FIRST DAY OF CLASS *FAILURE TO RESPOND WITH INQUIRY VIA EMAIL, CALL & TEXT, FOR VERIFICATION YOU ARE ALREADY CO NSIDERED DROP-OUT. NO ADMISSION SLIP, NO ENTRY.

FOR MORE INQUIRIES: CONTACT US @ 0997-5023105 / 8361-5743 Mark Angelo D. Ronquillo

OR EMAIL US manpowertrainingcenter@gmail.com Conforme: ___________________________________
LPCMTC – FORM No. 001 – 2022
Student’s Signature over Printed Name
REVISED: 04/25/2023 (Actual or Digital signature is required to be validated)