Instructions:

Only direct descendants of _________ are required to accomplish this form. This form
should be submitted on or before ____ together with the required Registration Fees of the
person/s accomplishing this form as well as those of his/her children and guests.
REUNION 2013 PRE-REGISTRATION FORM
Name: ________________________________________________ Nickname: ______________
Last Name

First Name

Middle Name

Status: ____________Gender: ____________Age: ___________ Date of Birth: ______________

Home Address: ____________________________________________Tel. No.: ______________
Cell No.: _______________________________ E-mail Address: __________________________
Occupation: ____________________________ Address: _______________________________
Name of Spouse: _______________________________________ Nickname: _______________
Names of Children: _____________________________________ Nickname: _______________
_____________________________________ Nickname: _______________
_____________________________________ Nickname: _______________
_____________________________________ Nickname: _______________
_____________________________________ Nickname: _______________
_____________________________________ Nickname: _______________
_____________________________________ Nickname: _______________
_____________________________________ Nickname: _______________
_____________________________________ Nickname: _______________
PARENTS
Father: ________________________________________

Deceased [ ]

Mother: _______________________________________

Deceased [ ]

PATERNAL GRANDPARENTS

MATERNAL GRANDPARENTS

Grandfather: __________________ Deceased [ ] Grandfather: ________________Deceased [ ]

Grandmother: _________________ Deceased [ ] Grandfather: ________________Deceased [ ]

Mode of Arrival in Bacolod City: (Please Check)

Airplane [ ]

Ship [ ]

Bus [ ]

Port/Terminal: ________________________ Date: ________________ Time: _______________

Pick up upon Arrival: Yes [ ] No [ ]

Hotel/Room Accommodation: Yes [ ] No [ ]

Number of Passengers:___________________

Number of Guests: ____________________

Contact Persons: Faith Plaza

09994620797

Eleanor Castro

XXXXXXXXX

Registration Fee is @ P600.00/person for Adults, P300.00 for Children (12 years old and below)
Amount: P_________________ Cash [ ] Bank Deposit [ ] Check [ ] Money Remittance [ ]
Receiver for B/D:______________ / Check No: _______________ /Control No: _____________
Shirts (Adult Size)
Children

Small: _____ Medium: _____ Large: _____ Xlarge: ______ XXLarge: _____
Small: _____ Medium: _____ Large: _____ Xlarge: ______

Total Number of Shirts: ________________

Total Number of Attending Family Members:

____________

Total Number of Attending Guests (friends/unmarried partner/visitor):

____________

Total Number of Attendees:

____________

Note:
We are soliciting additional funds to afford participation of other members of the family
and for activity prizes. Your generosity is highly appreciated.