Name of Academic Institution

Academic Institution's Complete Address

COUNCIL INFORMATION Name of Academic Institution's Head

Administrator/ Principal

Name of Council President

Mobile # & Email Address

Name of Lead Parent
Mobile # & Email Address

RCY Council Category (Junior RCY Council,

MEMBER INFORMATION Senior RCY Council, Senior Plus RCY Name of Council
Council, College RCY Council &
Community RCY Council)
 Date Council was
Organized:

Date Council was

Accredited by Chapter:

Date Council was

Accredited by National
HeadQuarters:

Full Name of Member Birthdate Age Gender

(dd/mm/yy)
Municipality Barangay Complete Address
Mobile Number Adviser Name Date of Recruitment MAAB Number
(dd/mm/yy)
Validity Date Emergency Contact Person Relationship to RCY Emergeny Person Contact
Member Number
Longitude, Latitude Member Status (active or TRAININGS TRAINING 1 TRAINING 2
inactive)
TRAINING 3 TRAINING 4 TRAINING 5 TRAINING 6 TRAINING 7 TRAINING 8 TRAINING 9
TRAINING 10 Awards AWARD DATE GIVEN AWARD
DATE GIVEN AWARD DATE GIVEN
 Name of Academic Institution JOHN B. LACSON FOUNDATION MARITIME UNIVERSITY - AREVALO, INC.

Academic Institution's STO. NIÑO SUR, AREVALO, ILOILO CITY

Complete Address

COUNCIL Name of Academic

INFORMATI Institution's Head CAPT. ALFRED ESPINOSA, PH.D.
ON Administrator/ Principal

Name of Council President MR. ERNESTO GRABATO, III

Mobile # & Email Address

Name of Lead Parent MR. JEFFREY LACSON

Mobile # & Email Address

RCY Council Category (Junior

MEMBER RCY Council, Senior RCY
INFORMATI Council, Senior Plus RCY Name of Council Full Name of Member
ON Council, College RCY Council
& Community RCY Council)
 Date Council
ARITIME UNIVERSITY - AREVALO, INC. was
Organized:
na
Date Council
was
REVALO, ILOILO CITY Accredited
by Chapter:
Date Council
was
Accredited
ESPINOSA, PH.D. by National
HeadQuarter
s:
O GRABATO, III

REY LACSON

Birthdate (dd/mm/yy) Age Gender Municipality Barangay Complete Address

 Date of Emergency
Mobile Number Adviser Name Recruitment MAAB Number Validity Date Contact Person
(dd/mm/yy)
Relationship to Emergency Longitude, Member TRAININ TRAINING TRAINING TRAINING TRAINING
RCY Member Person Contact
Number Latitude Status (active
or inactive) GS 1 2 3 4
TRAINING TRAINING TRAINING TRAINING TRAINING TRAINING DATE
5 6 7 8 9 10 Awards AWARD GIVEN AWARD
 DATE DATE
GIVEN AWARD GIVEN
 RCY Council Category (Junior RC
ADVISER Council, Senior RC Council, Senior
INFORMATION Plus RC Council, College RC Name of Council
Council & Community RC Council)
Full Name of Adviser Birthdate (dd/mm/yy) Age Gender
Municipality Barangay Complete Address Mobile Number Email Address
 Date of
Recruitment MAAB Number Validity Date
(dd/mm/yy)