MD Korean Language Tutorial Center Inc.

Arellano St., Dagupan City, Pangasinan

(075) 615-0741 / 0999 857 2916 / 0917 114 5255

REGISTRATION FORM
2 Weeks Free Training Program 2x2 Size Picture

Date: July 26 2021

NAME: DACUTAN JIMPHOL SERRA

Last Name First Name Middle Name

ADDRESS: RIYADH SAUDI ARABIA

CONTACT NUMBER: +966565417913 DATE OF BIRTH: MARCH 14, 1994 AGE: 27

CIVIL STATUS: SINGLE PLACE OF BIRTH: LINAO MATALAM COTABATO SEX: MALE

CITIZENSHIP: FILIPINO RELIGION: ROMAN CATHOLIC

HEIGHT: 157CM WEIGHT: 63KG MARKS:

EMAIL ADD: dacutanjimphol@gmail.com PASSPORT #: P9266133A EXPIRED ON: OCTOBER 22,

2028

Contact Person In Case Of Emergency: JOSIE DACUTAN / 09351953935

Complete Name and Contact No.

WORKING EXPERIENCE (From Past to Present)

COMPANY NAME: ADDRESS: DATE: POSITION:
MONTREUX COFFEE SHOP TAKHASSUSI RIYADH DECEMBER 12, 2019 UP TO PRESENT WAITER/BARISTA

S CLAIRE CITY LOUNGE KIDAPAWAN CITY FEBRUARY 15 2012 FOOD AND SERVICE

FRASER SUITES SATHORN URBANA BANGKOK THAILAND MAY 26- OCTOBER 20, 2012 HOUSEKEEPING _

EDUCATIONAL BACKGROUND
SCHOOL: COURSE: YEAR: GRADUATED:
UNIVERSITY OF SOUTHERN MINDANAO BS POLITICAL SCIENCE 2018

STI COLLEGE VOCATIONAL 2012

“WE ARE NOT A RECRUITMENT AGENCY; WE ARE A TUTORIAL CENTER”

Signature over Printed Name

 STUDENT AGREEMENT FORM

DATE: JULY 26, 2021

I, JIMPHOL S. DACUTAN student enrolled in MD KOREAN LTC on JULY 26,

2021 understand, agree and abide to follow rules and guidelines set by
M.D. Korean Language
Tutorial Center, pertaining to our enrollment as follows:

1. Tuition Fee is absolutely FREE, and the purpose of these training is for employment
under EPS-TOPIK.
2. Enrollment in the above-mentioned course is non-transferable and that trainees should attend
morning class 9:00am to 12:00pm Monday to Friday until the end of the course.
3. Trainees agreed not to use cellphones, tablet, or any gadget while on training. Taking
videos or photos are NOT ALLOWED unless otherwise approved by the management.
4. M.D. KOREAN LANGUAGE TUTORIAL CENTER is an institution specially provides training course
for the local and overseas employment. It is NOT a recruitment / nor job placement agency
likewise involved in these activities, and therefore, M.D. KOREAN LANGUAGE TUTORIAL
CENTER holds no responsibility or liability for providing job opportunities to trainees.
5. Any violation to this agreement the management may expel, send out of the training
and banned the person in the training in any training the MDKLTC Inc. will conduct.

CONFORME:

Signature over Printed Name