Republic of the Philippines

DEPARTMENT OF EDUCATION
Region III
DIVISION OF NUEVA ECIJA
STO. DOMINGO DISTRICT

STO. DOMINGO PUBLIC ELEMENTARY SCHOOL

TEACHERS ASSOCIATION (SDPESTA)

APPLICATION FOR MEMBERSHIP

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Last Name First Name Middle Name Designation

Name of School: Contact Number:

Home Address:

Birthdate Gender Civil Status Citizenship

Place of Birth: Religion:

Name of Father: Name of Mother:

Name of Spouse: Occupation

Name of Children Date of Birth

Special Designated Beneficiary (For Single or Separated Member only):

This is to certify that I apply for membership to STO. DOMINGO PUBLIC ELEMENTARY SCHOOL TEACHERS
ASSOCIATION (SDPESTA) and hereby pledge to obey and support the constitution and by-laws of the organization.
Promote the aims and purposes of the Association, the welfare of its members, the success of the movement as a
whole.

Date/Year of Membership: ________________________

___________________________________
Signature over Printed Name of Member
Recommending Approval:

____________________________________ __________________________________

Approved:

JOVITA M. ABOGADO
Chairman of the Board