trainin centera REGISTRATION FORM forwordleoring 47 Dr Fe Det Mundo Medical Arts Busing, #11 Banawe cor Cardia St, Dota Josela, Quezon City 1118 « TL (02) 241 2037+ Mobile 0927 343 7233 + wou fdmtainingcentercom Enrollment Details C1 New Student C) Old Student C) AHA Student Old Student (IVT) Tobe iled-out by authorized personnel COURSE Cais Gacs O Basic wT = ome Cece Opals CIT Updates oven First Aid Cems CO Skills Enhancement aye a Oleus CO FLRP O other - PACKAGE oe Personal Information SURNAME GIVEN NAME MIDDLE NAME ID Photo vesionarion Co Cen Cistuvent —Clotersspeciys (__ sTHDAY We sex Date DFemate cowie starus NATIONALITY ADDRESS UNE AL ADDRESS UNE? CITY PROVINCE J WP covE Lt ENAILADORESS ‘MOBILE NO. OF omer contactn. PERSON TO BE NOTIFIED INCASE OF EMERGENCY J CONTACTO. | Professional Information PROFESSION POSITION HOSPITAL / COMPANY l company ADDRESS l PRCLICNO. EXPRYDATE | Educational Background COURSE / DEGREE l J YEAR GRADUATED | ST SCHOOL ATTENDEDSurvey Howo1D YOU KNOWABOUT ] Referal/Friends 1 Facebook Billboards CiPhitippine Nursing Directory FOMTRANING CENTER Ofiyers O twitter C1Blog Pages Dothr po COFOMTC Website CI Instagram Dotxph ‘wnyoIDyoucHoost = Accesible Training courses offered FOMTRAINING CENTER? EC} EDMTC credibility C] Former student Dother Accreditation Up to date facilities and equipment LAM ATTENDING THE COURSE BECAUSE l Memorandum of Agreement Itis within EDM Tiaining Centers vision to continue enhanced service tits clients andi is for this reason that this memorandum of agreement is hereby stated Moreover this agreement intends to explain the strict requisition forthe clients compliance withthe polices of FOM Tianing Center Section 1: COMPLIANCE The course may be composed of several parts; such as dates and sls testing, The noo days of taining wil depend ‘on the training course you choose to env Section 2: PAYMENT - Fees fo the training can be settled through full basis and installment basis +nstllment basis the registrant must pay a minimum reservation fe, which etles him a sok. the remaining balance shouldbe seed ono before the est, day of aang or suing the onentaon Oy Smee hous te regen fl to sere tg bates anthe eae spacey Rtrereore Snberstogd tat he tnng center ha the sleight ofr the eserabin cegaaess any saee grounds ah ander she slots Inereste egivans. ‘Full basis - Upon registration the client should have had paid the course fee in full, Section 3: ALTERATION OF SCHEDULE - Fees are non-refundable or non-transferable. ti thereupon understood that FOM Training Center shall not honor any ‘Condition or excuse, which incapacitate the trainee to continue withthe training. Dates and Schedules of training may change and be moved {S'another date depending on external factors such as no of eavalies, schedule of trainer ee “Transfer of Schedule - Transfer of schedule requires a transfer fe of SO0Php. The customer has the opportunity to move his/her schedule ONCE. FOM Tein Centr Sal ris te tang fejreaeraton fee tne Customer Contest Wansler forte scan ime. ° “Downgrade of Inclusion itis thereby understood that Downgrade of Taining/Package shall require a fe of 1000Php. Reason for downgrade and necessan sects imstae Se Sobited byte intone Selon tre eapes an Oe appioved. is se dren of the masogement Aah request Shall be approve “Upgrade of Inclusion - The customer shal be given the opportunity to upgrade his/her traning/package within 24 hours upon the time of eavalment. After 24 a Buran equesto he customer to upgrade Soa be ender indulduaed ee Sal be aad. Section 4: CONTACT.CONSENT- This highlghts the time and dat inthe proces of information dissemination ofthe customer's needs, especially the updates of EDM Taming ener which includes an forms a altefations of te envole’ sched, upates and current promotions fhe ain ene, Section 5: PRIVACY POLICY ry private and conten nfomaton of he customer shal nt be used fr any maretng colar of the company name agdiess, BR License information, and company & work information since the use of such detals i or references only Any gener information ‘wl Be Subjected tothe use of the companys Marketing collaterals with the consent ofthe customer, Section 6: ANTI-PIRACY ACT- Any materials and services that FDM Training Center ov should not be duplicated or replicate it shall remain confidential unless ithas a special permission granted by tre company Any forms of replication shall resutt to legal mplications granted by the court ofa This to cer my therough understanding af the above-mentioned conton tis for ths eason that uly submit mel othe pals set forth by FDM Training Center. Moreover hereby declare any Information written therein contains ful integrity and confidentiality: if any records of falsifiations should be found on this, am duly responsible for any implications. “ia oe Name Eee Tae PRC LICENSE ‘Sled in the presence of Tptae or Rate ame aa Tae