MEDINA TEACHERS, RETIRESS AND EMPLOYESS ASOCIATION (MEDTREA)

MEDINA, MISAMIS, ORIENTAL

MEMBERSHIP FORM

Name of Member: MA. CHLOEE MARLOWE C. ALABA 1x1

Surname: ALABA
First Name: MA. CHLOEE MARLOWE
Middle Name : CAGAMPANG
Address : 698 TION-ALABA STS., NORTH POB., MEDINA, MIS.OR Present Station:_KIBUGAHAN ES
____________________________
Date of Birth :_OCTOBER 18, 1993 Place of Birth : CARMEN, CDO CITY
Civil Status : MARRIED

Prepared by:
ROLANDO Y. VALLESPIIN
Schoolhead
Reviewed by:

ELLY H. LOFRANCO
PS District Supervisor

Recommending Approval: APPROVED:

__________________________ ___________________________
Assistant Schools Division Superintendent Schools Division Superintendent

Contact No# 09177702224

Spouse Name : ZAPORTIZA ULYSSES GABIA

(Surname) (First Name) (Middle Name)
Beneficiaries:

Name Date of Birth Relationship

1. ULYSSES G. ZAPORTIZA AUGUST 10, 1990 HUSBAND
2. CLEOFE MARY C. ALABA SEPTEMBER 24, 1956 MOTHER
3.VICTORIA C. ALABA JANUARY 22, 1960 AUNT
4.

Status in DepEd: In the service Retired

I hereby certify that I am willing to become a member of MEDTREA and shall willingly
submit to the objectives of the organization in order to promote its cause for the interest of the general members.

MA. CHLOEE MARLOWE C. ALABA

(Signature Over Printed Name)
Recommending Approval :
ROLANDO Y. VALLESPIIN
School Head

Attested : Having paid the membership fee

CLAVEL C. LAGRIA
Treasurer
Approved : RICKY B. ABAO

President
 ACKNOWLEDGEMENT RECEIPT ACKNOWLEDGEMENT RECEIPT

Date: ___________ Date: ___________

Received from__________________________ Received from__________________________

Amount: ___________________________ Amount: ___________________________

Payment: ______Membership Payment: ______Membership

____Death Aid: ________________________________ ____Death Aid: ________________________________

______________________________________________________ ______________________________________________________

CLAVEL C. LAGRIA CLAVEL C. LAGRIA

MEDTREA TREASURER MEDTREA TREASURER

ACKNOWLEDGEMENT RECEIPT
ACKNOWLEDGEMENT RECEIPT
Date: ___________
Date: ___________
Received from__________________________
Received from__________________________
Amount: ___________________________
Amount: ___________________________
Payment: ______Membership
Payment: ______Membership
____Death Aid: ________________________________
____Death Aid: ________________________________
______________________________________________________
______________________________________________________
CLAVEL C. LAGRIA
CLAVEL C. LAGRIA MEDTREA TREASURER
MEDTREA TREASURER

ACKNOWLEDGEMENT RECEIPT
ACKNOWLEDGEMENT RECEIPT
Date: ___________
Date: ___________
Received from__________________________
Received from__________________________
Amount: ___________________________
Amount: ___________________________
Payment: ______Membership
Payment: ______Membership
____Death Aid: ________________________________
____Death Aid: ________________________________
______________________________________________________
______________________________________________________
CLAVEL C. LAGRIA
MEDTREA TREASURER CLAVEL C. LAGRIA
MEDTREA TREASURER

ACKNOWLEDGEMENT RECEIPT
ACKNOWLEDGEMENT RECEIPT

Date: ___________
Date: ___________

Received from__________________________
Received from__________________________

Amount: ___________________________
Amount: ___________________________

Payment: ______Membership
Payment: ______Membership

____Death Aid: ________________________________

____Death Aid: ________________________________
______________________________________________________
______________________________________________________

CLAVEL C. LAGRIA
CLAVEL C. LAGRIA
MEDTREA TREASURER
MEDTREA TREASURER