Volunteer Youth Leaders for Health - Philippines

Empowering the Youth for Health

Institute of Human Genetics, National Institutes of Health – UP Manila
Visayas Cluster Office: Newborn Screening Center Visayas, Jaro, Iloilo City
vylhvisayas@gmail.com | vyl_philippines@yahoo.com | www.sites.google.com/sites/vylhphilippines
http://www.facebook.com/vylhphilippines

PARTICIPANT’S INFORMATION SHEET

Full Name:
(Last, Given Middle) Lomarda, Louise Faith Crame
Nickname: Faith Age: 19 Sex: Female
Birth date: October 27, 1999 Marital Status: Single
Religion: Roman Catholic Shirt Size: XS/ 20
Home Address Current Address
Insert
Lot/Street: Lot/Street:
2x2 Picture
Brgy/District: Las Salinas Sur Brgy/District: Las Salinas Sur
Here
Town/City: Loay Town/City: Loay
Province: Bohol Province: Bohol
Region: 7 Region: 7
Cluster Cluster
Special Skills/Talents: Dancing, Singing, Karate
Contact Information Educational Background (Upon Membership)
Mobile#: 090984954836 High School Year Level:
Landline#: College Course, Year Level: BS Criminology, 1st year
Fax#: Name of School/University: University of Bohol
Email: louisefaithhopelove@gmail.com Year of Graduation (If applicable):
Facebook: Louise Faith Lomarda Employment (If Applicable) Further Studies (If Applicable)
Twitter: Profession: Course
Skype: Occupation: Year:
Other Social Media: Employer: School:
In case of emergency, please notify: Address: Address:
Name: Verna C. Lomarda Previous work experience/ Position:
Relationship: Sister Insurance Purposes
Contact #: 09105287676 Mother’s Name: Vicenta C. Lomarda Mother’s Birthday: January 22
Organization Information: Father’s Name: deceased Father’s Birthday:
☐ School-based
VYLH MEMBERSHIP HISTORY
☐ Community-based
It was last year during my senior high school days when our
University of Bohol teacher in the person of Ma’am Reina Galo told us about the
Name of School How did you know about
Tagbilaran City said organization. She introduced us with my friend Donna then
or Community: VYLH-Philippines?
Most Holy Trinity Parish of Loay she told us to post a short video about ourselves and about to
the organization.
Dr. Cecilio Putong St. Tagbilaran
Address: VYLH BATCH Month, Year:
City (Pioneer, K4, I3, E4, etc.)
Hayaw November 2018
Pob. Ubos, Loay, Bohol
Ms. Mitzi Ente (Pillars of
Justice)
Ms. Katherine Gayle Duco
(PYM) Cluster Migrated to &
President: Cluster Origin: Visayas
Ms. Ana Mae Abero (BLD) Date of Transfer:
Ms. Alyssa Hana Bag-ao
(LSYM)

Pillars of Justice
Parish Youth Ministry
Organization VYLH Positions
Represented (if any): Bukas-Loob sa Diyos (Position, Year):
Las Sal Youth Ministry

Member (POJ, BLD) C& C Attendance 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Press Relation Officer
Organization Position/
(PYM)
Designation (if any): Camps Attended: ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☒ ☐ ☐
Vice President (LSYM)
 Mr. Marven Jumawid
(POJ)
Fr. Ryan Montealto (PYM)
Organization
Fr. Lito Geangan (BLD)
Adviser/Dean: Congress Attended: ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Mr. James Royd Mahinay
(LSYM)

Other Organization(s)
Personal Statement (To be filled during camp proper)
and years of membership:
Organization Contact information:
I hereby certify upon my honor that all facts and information indicated herein are true and correct to the best of my
Mobile#: knowledge.
Landline#: The undersigned expressly authorizes the Volunteer Youth Leaders for Health – Philippines or its representatives
to use, share, and process my personal information.
Fax#:
IN WITNESS hereof, I am executing and signing this statement voluntarily without compulsion.
Email:
LOUISE FAITH C LOMARDA November 15, 2018
FB Page: Applicant’s Name, Signature Date