Student Registration Form
Fill out the form carefully for registration
Course?
*
Please Select
SMAW NC1
Japanese Language
Student Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student E-mail
*
example@example.com
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
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5
6
7
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30
31
Day
Please select a year
2024
2023
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2015
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2012
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2005
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2002
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2000
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1996
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1994
1993
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1991
1990
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1988
1987
1986
1985
1984
1983
1982
1981
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1975
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1957
1956
1955
1954
1953
1952
1951
1950
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1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
BIRTHDATE
*
-
Month
-
Day
Year
Date
EDUCATIONAL ATTAINMENT
*
Please Select
NO GRADE COMPLETED
ELEMENTARY UNDERGRADUATE
ELEMENTARY GRADUATE
PRESCHOOL (NURSERY/KINDER/PREP)
POST SECONDARY UNDERGRADUATE
POST SECONDARY GRADUATE
HIGH SCHOOL UNDERGRADUATE
COLLEGE UNDERGRADUATE
JUNIOR HIGH GRADUATE
HIGH SCHOOL GRADUATE
COLLEGE GRADUATE or HIGHER
SENIOR HIGH GRADUATE
CIVIL STATUS
*
Please Select
SINGLE
MARRIED
WIDOW/ER
SEPARATED
SOLO PARENT
EMPLOYMENT STATUS (BEFORE THE TRAINING)
*
Please Select
EMPLOYED
UNEMPLOYED
Mobile Number "WITHOUT 0"
*
Gender
*
Please Select
Male
Female
N/A
BIRTHPLACE
*
CITY/MUNICIPALITY
PROVINCE
REGION
Learner/Trainee/Student (Clients) Classification PT 1:
*
Please Select
STUDENTS
OUT-OF-SCHOOL-YOUTH
SOLO PARENT
SOLO PARENT'S CHILDREN
SENIOR CITIZEN
Displaced HEI's Teaching Personnel
DISPLACED WORKERS
TVET TRAINERS
CURRENTLY EMPLOYED WORKERS
EMPLOYEE WITH CONTRACTUAL
TESDA ALUMNI
URBAN AND RURAL POOR
N/A
Learner/Trainee/Student (Clients) Classification PT 2:
*
Please Select
INFORMAL WORKER
INDUSTRY WORKER
COOPERATIVE
FAMILY ENTERPRISE
MICRO ENTREPRENEUR
FAMILY MEMBERS OF MICRO-ENTREPRENEUR
EMPLOYMENT COORDINATOR
RETURNING/REPARTRIATED OFW
OFW DEPENDENTS
PERSONS WITH DISABILITIES
N/A
Learner/Trainee/Student (Clients) Classification PT 3:
*
Please Select
Indigenous people & cultural comunities
Disadvantaged Women
Victim of Natural Disasters
Victim or Survivor of human trafficking
Rebel Returnees
Inmate or Detainees
Wounded-in-action AFP & PNP personel
Family Member of AFP & PNP personel
Family Member of inmates and detainees
Uniformed Personel
N/A
Parent/Guardian
*
Full name
Complete Permanent Mailing Address
Privacy Disclaimer
*
Please Select
AGREE
DISAGREE
i hereby allow LPSCI to use/post my contact details, name, email, cellphone/landline nos. and other information i provided which maybe used for processing of my scholarship application, for employment opportunities and other purposes
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