Al

phaPhi
Omega
PHI
LIPPI
NESI
NCORPORAT ED
Bic
olAdmini
st
rat
iveRegion
Secti
on2-Camari
nesSur
BUHI
ALPHAPHIOMEGAALUMNIASSOCI
ATI
ON
BAPOAACha
rte
rNo.
304|Buhi
,Ca
mar
ine
sSur
,Phi
l
ippi
nes

ALUMNIMEMBERSHI
PFORM

Ki
ndl
yfi
l
loutt
hismember
shi
pappl
i
cat
ioni
npr
intl
egi
bly.

I
.PERSONALI
NFORMATI
ON

Name:
Sur
name Gi
venName Mi
ddl
eName

Dat
eofBi
rt
h: Bl
oodType: Age: Pr
of on:
essi
mm/
dd/
yyy

Pr ess:
esentAddr
House#/
str
eet Bar
angay Muni
ci
pal
i
ty/
Cit
y Pr
ovi
nce Zi
pCode

Emai
lAddr
ess: Mobi
l
eNumber
:

I
I.FRATERNI
TY/
SORORI
TYI
NFORMATI
ON

Bat
chName: Bat
chYear
/Semest
er:

APOI
DNumber
: Val
i
dit
y:

Dat
eofRegi
str
ati
on

Chapt
erI
nit
iat
ed: Chapt
erCode: Ri
tualDat
e:

Col
l
ege/
Uni
ver
sit
yIni
ti
ated:

NameofGr
andChancel
l
or/
GLC:

NameofPr
imeChancel
l
or/
PLC:

MEMBERSHI
PAFFI
RMATI
ONPLEDGE
Idecl
areunderoat
hthatt
heabovei nf
ormat
ionisat r
ue,corr
ectandcompl etedatapur suanttomyappl
icat
ion.I
author
izet
heBAPOAACoMet over
ify/
val
idat
ethecontent
sstat
edherei
n.Iagreethatanymi srepresent
ati
onmadeinthis
documentshal
lcauset
hefi
li
ngofgr
ievanceacti
onpursuantt
othelawsoftheassociat
ionagainstme.
If urther aff
irmt hatIshallabidebyourBAPOAA CodeofBy- Laws;compl ywi thalll
awfulordersofourdul y
const i
tutedl eader
ship;mai nt
ainmygoodst andingbyf
ulf
il
li
ngthedut
iesofmember ship;endeavortoreali
zetheideal sof
theor ganizat i
onbyexcel l
inginmychosenf i
eld,byext
endingahandoff ri
endshiptoallregardl
essofrace,rel
i
gion,social
class,orpol i
ti
cali
deology,andbyunsel fi
shlygivingmyti
meandenergyi npur sui
ngapr ogr
am ofservi
ceforourfraterni
ty
andsor ori
ty,tothestudent sanduniversi
ty,totheyout
handcommuni ty,andtot henationasaf ull
yparti
ci
pati
ngci t
izen.I
shall,i
nal lmydeal ings,upholdthedignit
yofAl phaPhiOmegabygoodexampl ethr
ought houghts,wor
ds,anddeeds.

Si
gnat
ureoverPr
int
edSi
gnat
ure Dat
eSi
gned

BAPOAA Commi
ssi
ononMember
shi
p:_____________________(
signat
ureoverPr
int
edName)
Dat
eMember
shi
pFeePai
d:________ Amount
:_______ OR#/
Ctr
lNo.
:_________