Webmaster
Admin
Posts : 44
Points : 80
Join date : 2012-03-01
Age : 40
Location : Quezon City
 | Subject: Registration Form  Fri Sep 07, 2012 5:42 am | |
| 1.) Copy Template 2.) Create New Topic ( Ex: Michael A. Madayag Registration Form ) 3.) Fill out template Form Then Save For Payment Temporary PM Pres. Eran Del Rosario for more Info __________________________________________________________________________________ GUPPY CLUB PHILIPPINES
*11 Augustus St. BF Resort Village, Las Piñas City,
Philippines Email: [Only admins are allowed to see this link] ) +639209153726 MEMBERSHIP
APPLICATION
| APPLICANT
INFORMATION
| Name:
| Date
of birth:
| Phone:
| Mobile:
| Current
address:
| City:
| Province:
| ZIP
Code:
| EMPLOYMENT
INFORMATION
| Current
employer:
| Employer
address:
| How
long?
| Phone:
| E-mail:
| Fax:
| City:
BULACAN
| Province:
BULACAN
| ZIP
Code: 3
| Position:
| EMERGENCY
CONTACT
| Person
to notify in case of emergency:
| Address:
| Phone:
| City:
| Province:
| ZIP
Code:
| Relationship:
| HOBBY
INFORMATION
| Years
in Guppy Keeping/Breeding:
| Number
of Guppy Strain(s):
| Number
of Tank(s):
| Other
Fish:
| Current
Guppy Strains:
| Reason
for Joining the Club:
| EDUCATIONAL
BACKGROUND
| High
School:
| Address:
| From:
| To:
| Did
you graduate?
| Degree:
| College:
| Address:
| From:
| To:
| Did
you graduate?
| Degree:
| Other:
| Address:
| From:
1996
| To:
| Did
you graduate?
| Degree:
| SIGNATURES
| I
certify that all information provided in this form is accurate to the best of
my knowledge. I also agree to abide the club rules and regulations and
fulfill my obligation as its member.
I
am agreeing to pay the membership fee annually (Every 1st of July) as
follows:
o
500 – New Member
o
400 – Renewal
| Signature
of applicant:
| Date:
| | |
|
