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PARTIDO DEMOKRATIKO

PILIPINO
LAKAS NG BAYAN
(PDP

LABAN)
Please

MEMBER’S DATA SHEET

submit two
copies of
your 1x1 ID

Please write down clearly. Mark appropriate boxes  with or .
ID Number (O.R. Number)

Date of BMS

First Name

Gender

Place of BMS

Middle Name

Nickname

Telephone Number

 Male

Age

picture.

Date of Birth

Email Address
Name of Spouse, if married

Place of Birth
Street / Purok No.

Barangay

Suffix

Cell Phone Number

Civil Status

 Female

House No. / Lot No. / Block No.

Last Name

Religion
Subdivision / Sitio / Neighborhood

City / Municipality

Province

District

Educational Attainment

Profession / Occupation / Sector

Name of School/Level/Degree:

 Elected Official/Position:_____________________

 Gov’t Employee

 Entrepreneur

 Self-employed

Year Graduated:

 Cooperative / NGO

 Private Employee
 Unemployed
 Other:_______________
Membership/Involvement/Employment with other Organizations/Companies/Agencies

Organization / Company / Agency

Person to be notified in case of emergency

Designation

Year Joined / Term

Contract Number

R O O M 4 0 4 , 4 T H F L O O R , B E L - A I R A PA RT M E N T , 1 0 2 0 R OX A S B LV D . , E R M I TA , M A N I L A
 (02)354-9010 / (02)358-8813  pdplaban.nhq@gmail.com / pdplaban.roxasblvd@gmail.com

partidoPDPLABAN

1 0 2 0 R OX A S B LV D . No. 4 T H F L O O R .roxasblvd@gmail.nhq@gmail. . Date Issued Date: R O O M 4 0 4 .com / pdplaban. E R M I TA .A I R A PA RT M E N T . M A N I L A  (02)354-9010 / (02)358-8813  pdplaban.com partidoPDPLABAN .PARTIDO DEMOKRATIKO PILIPINO LAKAS NG BAYAN (PDP LABAN) ___________________________________________________ Name of Member & Signature (Please sign over printed name) Recruited by: Conducted by: One Time Membership Fee Amount Paid: ____________________________ Chapter Head/Coordinator (Please sign over printed name) ____________________________ Party Trainor (Please sign over printed name) Database Entry Encoder: O. B E L .R.

Pagkakapantay-pantay at Kasarinlan. .  iaalay ko ang aking sarili sa masalimuot ngunit kinakailangang tungkulin para sa ikauunlad ng bawat mamamayang Pilipino at sa Kalayaan ng Bayan.A I R A PA RT M E N T . si ________________________________________________________________________ ng ________________________________________________________________________ lungsod ng ________________________________________________________________________ na tinanggap bilang kasapi ng PARTIDO 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. Pananagutang Panlipunan. Lahat ng ito ay aking tinanggap ng kusang-loob at walang pasubali. Mabisang Katarungan.nhq@gmail. B E L . 4 T H F L O O R . E R M I TA . Pagkilos.com partidoPDPLABAN .com / pdplaban. R O O M 4 0 4 . 1 0 2 0 R OX A S B LV D . Pagkakaisa. KASIHAN NAWA AKO NG MAYKAPAL. Pagkamakabayan at Pederalismo.  itataguyod ko at makikiisa sa mga pagkilos ng Partido.  susundin ko ang mga alituntunin at patakarang ipatutupad ng mga kinauukulang pamunuan ng Partido.roxasblvd@gmail. M A N I L A  (02)354-9010 / (02)358-8813  pdplaban.PARTIDO DEMOKRATIKO PILIPINO LAKAS NG BAYAN (PDP LABAN) PANUNUMPA Ako.

PARTIDO DEMOKRATIKO PILIPINO LAKAS NG BAYAN (PDP LABAN) Nilagdaan ngayong ika-_____ ng ______________________________ taon _____. E R M I TA . _________________________ Lagda ng Kasapi Pinagtibay: _________________________ Lagda ng Pinuno R O O M 4 0 4 .com partidoPDPLABAN . M A N I L A  (02)354-9010 / (02)358-8813  pdplaban. 4 T H F L O O R . .roxasblvd@gmail.nhq@gmail.com / pdplaban. 1 0 2 0 R OX A S B LV D . B E L .A I R A PA RT M E N T .

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