Nagkakaisang Samahan Sa Distrito Dos

(NSDD)
SEC. Reg. No. CN201423500
Cert. No. 025-2015
\ #214 4th St. Bitoon Circle Brgy. Commonwealth. Quezon City

“NSDD PLUS QUUEZON CITY SUPPORT MARTIN G. ROMUALDEZ”

MEMBERSHIP FORM
I. Introduction
2x2

NAME: ______________________________________________

AGE: _____________BIRTHDAY: __________________________

SEX: __________________STREET ADDRESS: _______________________

BARANGAY: _______________________DISTRICT: ____________ STATE: __________

CONTACT NUMBER: _______________________ PRECINT NO.: ________________

II. Family Members

NAME AGE OCCUPATION PRECINT NO.

I, ________________________ of the _________________________ do hereby affiliate and

confirm my membership with the Nagkakaisang Smahaan ng Distrito Dos (NSDD) and hereby
solemnly swear that I shall uphold and support the goals and objectives of the organization.

Rizza T. Peña
President
Nagkakaisang Samahan ng Distrito Dos (NSDD)