Registration

Registration form

Milliard Driver Training Institute

Registration Form Vol
1.NAME *

NAME FATHER'S NAME GRANDFATHER'S NAME
2.ADDRESS *

sub-city

Street Address Line 2

DISTRICT HOUSE NUMBER
3.PHONE NUMBER *

PHONE NUMBER
4.DATE OF BIRTH *

Month Day Year
Date of Birth
5. IF YOU HAVE A DRIVING LICENSE BEFORE
No
6.TYPE OF DRIVER'S LICENSE REQUESTED *
7.I DON'T HAVE EPILEPSY, HEART FAILURE AND HIGH BLOOD PRESSURE; THAT ALL PREVIOUSLY FILLED IN IS CORRECT *

confirmed it
8.DATE OF REGISTRATION *

Month Day Year
TODAY'S DATE
Should be Empty:

Our Address
Milliard Driving Scool Registration Center,
Summit Safari Chaloni, Kaldis Building
Addis Ababa

Phone
+251 986220000
+251985202222

Email
milliardhaile19@gmail.com