Iglesia Filipina

Independiente
1500 Taft Avenue, Ermita, Manila

LAYMEN INDIVIDUAL SURVEY FORM

Parish_____________ 2x2
Diocese____________
picture
Name: ________________________________

Position: _________________________

Age: _________ Civil Status: __________ Date of Birth: ____________

Home Address: _________________________________________________

Contact No(Fax/Landline/Mobile) _________________
(please inform DLEC every time you change contact no.)

E-mail Address: ________________ Lifetime Membership:________

Monthly due details:

JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DEC

Educational Attainment: ______________________________

Occupation: ________________________________________

Company Address: ___________________________________

Contact No.: ________________________________________

_________________ _______________ _________________

Signature of Member LIFI President Parish Priest

Note: Please write legibly in print