(PDP
L A BA N )
APPLICATION FOR MEMBERSHIP
Please submit
two copies of
your 1x1 ID
AND ASSOCIATE DATA SHEET
picture.
Please write down clearly. Mark appropriate boxes with or .
ID Number (O.R. Number)
Date of BMS
First Name
Middle Name
Nickname
Telephone Number
Gender
Place of BMS
Last Name
Cell Phone Number
Civil Status
City / Municipality
Educational Attainment
Email Address
Name of Spouse, if married
Male
Age
Date of Birth
Place of Birth
Female
House No. / Lot No. / Block
Street / Purok No.
No.
Barangay
Suffix
Religion
Subdivision / Sitio /
Province
Neighborhood
District
Profession / Occupation / Sector
Name of School/Level/Degree: Elected Official/Position:_____________________
Govt Employee
Year Graduated:
Entrepreneur
Cooperative / NGO
Self-
employed
Private Employee
Unemployed
Other:_______________
Membership/Involvement/Employment with other Organizations/Companies/Agencies
Organization / Company /
Agency
Designation
Year Joined / Term
2440-B 2ND FLOOR, F.B. HARRISON ST. CORNER PALM COURT, PASAY CITY
(02)264-6111 pdplaban.pasaynhq@gmail.com
partidoPDPLABAN
(PDP
L A BA N )
Person to be notified in case of emergency
Contract Number
___________________________________________________
Name of Member & Signature
Recruited by:
BMS Conducted by:
One Time
Database Entry
Membership Fee
Amount Paid:
Encoder:
___________________
___________________
_________
_________
(Please sign over
Chapter
Party Trainor
printed name)
Head/Coordinator
(Please sign over
(Please sign over
printed name)
O.R. No.
Date Issued
Date:
printed name)
2440-B 2ND FLOOR, F.B. HARRISON ST. CORNER PALM COURT, PASAY CITY
(02)264-6111 pdplaban.pasaynhq@gmail.com
partidoPDPLABAN
(PDP
L A BA N )
PANUNUMPA
Ako,
si
__________________________
_________________________________________nanggap
ng
bilang
kasapi
lungsod
ng
DEMOKRATIKO PILIPINO LAKAS NG BAYAN (PDP LABAN) ay sumusumpa na:
itataguyod ko ang Saligang Batas ng Partido na kung saan
nakalahad ang aking paniniwala at paninindigan para sa
Kalayaan, Pagkakaisa, Katarungan, Pagkakapantay-pantay at
Pananagutang Panlipunan, Kasarinlan, Mabisang Pagkilos,
Pagkamakabayan at Pederalismo;
susundin ko ang mga alituntunin at patakarang ipatutupad ng
mga kinauukulang pamunuan ng Partido;
itataguyod ko at makikiisa sa mga pagkilos ng Partido;
iaalay ko ang aking sarili sa masalimuot ngunit kinakailangang
tungkulin para sa ikauunlad ng bawat mamamayang Pilipino at sa
Kalayaan ng Bayan.
Lahat ng ito ay aking tinatanggap ng kusang-loob at walang pasubali.
KASIHAN NAWA AKO NG MAYKAPAL.
Nilagdaan ngayong ika-_____ ng ______________________________ taon _____.
2440-B 2ND FLOOR, F.B. HARRISON ST. CORNER PALM COURT, PASAY CITY
(02)264-6111 pdplaban.pasaynhq@gmail.com
partidoPDPLABAN
ng
PARTIDO
(PDP
L A BA N )
_________________________
Lagda ng Kasapi
Pinagtibay:
_________________________
Lagda ng Pinuno
2440-B 2ND FLOOR, F.B. HARRISON ST. CORNER PALM COURT, PASAY CITY
(02)264-6111 pdplaban.pasaynhq@gmail.com
partidoPDPLABAN