LTO CLIENT ID No.
: _________________________________
__________________________________________________________________________________________________
FIRST NAME MIDDLE NAME LAST NAME EXT. NAME
ADDRESS: _________________________________________________________________________________
House No./Purok/Street Barangay City/ Municipality Province Zip Code
AGE: ________ DATE OF BIRTH: __________________ STUDENT PERMIT NO. _________________________
NATIONALITY: ____________ CONTACT NO: ________________ EMAIL ADDRESS: _____________________
CIVIL STATUS: Single Married Widowed Separated GENDER: Male Female
EDUCATIONAL ATTAINMENT: BIRTHPLACE: _________________
College High School Elementary Post Graduate BLOOD TYPE: _________________
Informal Schooling Vocational Kto12 None
EMEREGENCY CONTACT PERSON: ________________________
CONTACT NUMBER: ___________________ MOTHER’S MAIDEN NAME: _____________________________
TYPES OF APPLICATION SCHEDULE OF FEES
NEW AMOUNT
ADDING RESTRICTION / DL CODE COURSE PROGRAM
RENEWAL
PARTIAL FULLPAYMENT
TDC
DELIQUENT/DORMANT LICENSE
PDC
TYPE OF LICENSE APPLIED FOR DEP
STUDENT DRIVER’S PERMIT OR NUMBER:
NON-PROFESSIONAL
PROFESSIONAL
_________________________________ _______________________________
SIGNATURE OF APPLICANT CASHIER
ATTENDANCE MONITORING SHEET (PDC)
MOTORCYCLE/TRICYCLE (R1) MOTOR VEHICLE (R2) MOTOR VEHICLE (R4) DEP
STRAIGHT TRUCK & BUS (R3) ARTICULATED VEHICLE (R8)
DRIVERS LICENSE NO: _________________
DATE NO. OF SESSIONS STUDENT SIGNATURE
1
2
3
4
________________________________________________
DRIVER INSTRUCTOR’S SIGNATURE OVER PRINTED NAME
REMARKS
YES NO
1. PRE-DRIVING CHECK UP
1.1 THE BLOWBAGETS
1.2 PERFORM COCKPIT DRILL
1.3 USE SEATBELT / HELMET
1.4 DISENGAGE CLUTCH WHEN STARTING ENGINE
2. DRIVING SKILLS
2.1 STEERING 2.1. POSITIONING OF HANDS
1
2.1. SMOOTHNESS
2
2.1. TWO HAND GRIP
3
2.1. OVERSTEERING
4
2.2 ENGINE CONTROL 2.2. USE OF GEAR
1
2.2. CHOOSE OF GEAR
2
2.2. USE OF CLUTCH
3
2.2. USE OF ACCELERATOR
4
2.3 USING OF BRAKES 2.3. APPLY BRAKE SMOOTHLY
1
2.3. REACTIONS TO HAZARD
2
2.3. VEHICLES TURNING
3
2.4 SPEED CONTROL 2.4. SPEED LIMIT OBSERVATION
1
2.4. NEEDLESS STOP
2
2.4. OBSERVING TRAFFIC RULES
3
2.5 TURNING LEFT, TURNING RIGHT AND U-TURN 2.5. TAKES PROPER LANE
1
2.5. SIGNAL INTENTION
2
2.5. USE OF HAND AND LIGHT SIGNAL
3
2.6 BACKING 2.6. NUMBER OF ATTEMPTS
1
2.6. TURNING RIGHT AND LEFT
2
2.6. CONTROL OF VEHICLE/TRAILER
3
2.7 PARKING 2.7. NO. OF ATTEMPTS (PARALLEL,
1 PERPENDICULAR, ANGLE PARKING)
2.8 MANUEVERING 2.8. THE “Y” TURN
1
2.8. PERFORMING SLALOOM
2
2.9 HANGING 2.9. UPHILL (3% GRADE)
1
2.9. DOWNHILL (3% GRADE)
2
2.10 HIGHWAY DRIVING AND HEAVY TRAFFIC
2.11 LIGHT DRIVING
3. OBSERVANCE TO TRAFFIC RULES
3.1 RIGHT OF WAY 3.1. APPROACHING TO INTERSECTION
1
3.1. CHANGING LANES
2
3.1. PASSING / BEING PASSED
3
3.2 STOP LIGHT/SIGNALS AND OTHERS 3.2. OBEY TRAFFIC SIGNS
1
3.2. POSITION AFTER STOPPING
2
3.2. MAKING FULL STOP WHEN NECESSARY
3
3.2. ANTICIPATING BEFORE SIGNAL CHANGES
4
3.2. OBSERVANCE ON PEDESTRIANS
5
3.3 RIGHT OF WAY 3.3. FOR PEDESTRIANS
1
3.3. FOR EMERGENCY
2
3.3. YIELDING OF RIGHT OF WAY
3
3.3. FOR BICYCLIST
4
COMMENTS / RECOMMENDATIONS RECOMMENDED FOR RC’S - DL CODE/S: APPROVED / DISAPPROVED BY:
SIGNATURE OVER PRINTED NAME
DRIVER INSTRUCTOR
WAIVER of LIABILITY
I, _________________________________ acknowledge all the risk of personal injuries
including damage to the vehicle and other properties sustained during this Practical Driving
Course, and release the A&L Driving and Technical Training Center Inc. of any liabilities
arising during this course.
I hereby read and understand the contents of this document and sign voluntarily
below.
________________ _________________________________ ______________
SIGNATURE OF STUDENT SIGNATURE OVER PRINTED NAME DRIVER INSTRUCTOR DATE
PRACTICAL DRIVING MONITORING CHECKLIST
