6th MINDANAO BUSINESS AND MANAGEMENT YOUTH CONGRESS

“Pag-uswag Mindanao: Unleashing the Youth’s Entrepreneurial Spirit

Amidst Crisis”
February 5-7, 2010

c/o Xavier University School of Business and Management Student Council

2nd Floor, Student’s Center (STC) Building, Xavier University Main Campus, Corrales
Avenue
9000 Cagayan de Oro City

APPLICATION FORM
APPLICANT’S INFORMATION
NAME:

(Surname) (Given Name )

(M.I)
NICK NAME: AGE: SEX: RELIGION:

COURSE: CURRENTLY ENROLLED IN:

YEAR LEVEL: SCHOOL ADDRESS:

HOME ADDRESS:

HOME NUMBER: E-MAIL ADD: CELLPHONE NUMBER

(Include NDD area code) (Indicate only one) (Indicate only one)

IN CASE OF EMERGENCY
NAME OF CONTACT PERSON: __________________________________
CONTACT PERSON NUMBER: __________________________________
RELATION TO THE APPLICANT:
TO BE FILLED BY THE SECRETARIAT TO BE FILLED BY THE SECRETARIAT

FORM NO. REMARKS:

DATE RECEIVED:

I certify, to the best of my knowledge that all information presented in this

application
form is accurate and valid. Any misrepresentation shall automatically
disqualify me from joining
the 6th MBMYC.

Applicant’s Signature

__________________
Date