Share

Application for Accreditation as Driving School Instructor (NEW)

LTO application form for accreditation as driving school instructor

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: APPLICATION
FOR ACCREDITATION AS DRIVING SCHOOL INSTRUCTOR
Instruction:

Fill out this form completely and correctly in your own handwriting. Affix your
usual signature on the space provided thereof. Submit all necessary documents or
papers together with this application.

Warning:

You are liable for perjury for any false statement or entries you will write herein.
In addition, you will permanently disqualified as a driving school instructor as a
result thereof.

Name:
(Family)

(Given)

(Middle)

Address:
(No.)
(Sex)

(Street)
(Age)

(Town/City)
(Date of Birth)

(Province)
(Citizenship)

(Civil Status)

EDUCATION:

School Last
Attended

Inclusive Dates
of Attendance

Name of School

Degree Earned
Honors Received

Elementary

High School
College/
University
(Attached copy of diploma, certificate or transcript of records of last school attended and that of
vocational school)
OTHER TRAINING’S:

(Include all formal training, special studies and scholarship)

Nature or Skill

How Acquired

Where Acquired

EXPERIENCE AS DRIVER/DRIVING SCHOOL INSTRUCTOR

Inclusive Dates
From

Position

Name of School

Nature of Appointment

To

EXPERIENCE AS TRAFFIC LAW ENFORCEMENT OFFICER:
From

to

Position

Nature of Office

Nature of Appointment

HAVE YOU EVER BEEN INVOLVED IN A TRAFFIC ACCIDENT WHILE OPERATING A
MOTOR VEHICLE OR WHILE CONDUCTING A PRACTICAL DRIVING LESSON? NO:
_____ YES: _____ When?: ___________State particular and final adjudication of case, if any:
__________________________________________(If yes, attached copy of decision of court or
agency having jurisdiction over the case. If no, attached clearance from CHPG/LTO/Local
Police Department)
HAVE YOU EVER BEEN CHARGE OR CONVICTED OF ANY CRIME INVOLVING
MORAL TURPITUDE? NO: _____ YES: _____ When?: __________________ State particular
and final adjudication of case, if any: ______________________________________________
(If yes, attach copy of decision of court having jurisdiction over the case. If no, attach
certification of Barangay Chairman attesting to your moral character).

CURRENT DRIVER’S LICENSE : _______________________
NATURE OF ACCREDITATION DESIRED :
Classroom Instructor: _______

Practical Instructor: _______

I hereby certify that the foregoing statements and information are true and correct, and
accomplished in my own handwriting.

Signature of Applicant

Taxpayer Account Number

FOR ACCREDITATION AS DRIVING SCHOOL INSTRUCTOR/CLASSROOM
LECTURER
General Requirements:
1. Duly Accomplished Application form
2. Valid Professional Driver’s License
a. Practical – 5 years holder
b. Lecturer – at least 3 years
3. College Diploma/Transcript of Records
a. Practical – High School Graduate
b. Lecturer – 2nd year college
4. Examination Result – Pass
5. Certification of no apprehension and alarm on file/case
6. Police/NBI Clearance
 
Page of
Share