ITVET Toledo

Application Form

Personal Data

Name: ____________________________________________________________
(Last) (First) (Middle)

________________________________________________________________________
Address

Social Security #: __________________________ Expiration Date: ____________

Phone #: ____________________ Email: ____________________________

Date of Birth (dd/mm/yy): _______________ Age: _______ Sex (M/F): _________

Marital Status: Single _________ Married_____________ Common-law _____

No. of Family Members:___________

Father’s Name_________________ Telephone Number _______________

Mother’s Name ______________ Telephone Number _______________

In the Case of any emergency contact: Relationship ________________

Phone Number _______________

Do you suffer from any Medical Conditions? Please state ____________________

Program interested in (list first and second choices, 1 and 2):

_______ Recreational Tourism __Front Desk

_____Food Preparation

_____ Electrical Installation

_____ Auto Mechanics/Welding

_____ Horticulture
Educational Background

_____High School _____ Primary School _____ other

* Applicants are advised to submit a letter of recommendation.

Who will fund your education at ITVET (Please check one)?

_____ Self _____ Parent/Guardian

_____ Scholarship State agency: _______________________________

_____ Other Please state: ________________________________

I declare that the information given on this application is truthful to the best of my
knowledge.

Trainee
Signature: ___________________________________ Date: __________

Parent/Guardian

Signature: ___________________________________ Date: __________

Application Checklist

_____ Copy of Birth Certificate _____ Transcript or report card

_____ Recommendation letter ____ Copy of Social Security Card

Join us today! And learn a trade for your future.

ITVET Toledo
Crique Jute Village. Toledo District
742-4774
Email: itvettoledo@yahoo.com
www.pgbelize.com/itvet