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FRATERNAL ORDER OF Eagles

(Philippine Eagles)
First Philippine Born Fraternal Socio - Civic Organization
Service Through Strong Brotherhood
MAPITAGAN LAGUNA EAGLES CLUB
NCR XXIV MAPITAGAN

APPLICATION FORM FOR I.D.


NAME CLUB POSITION:
First Name Middle Name Last Name
Lemwil Aruta Saclay
HOME ADDRESS:
2844 Uruguay Street, brgy San Isidro, Makati City
PERSONAL CONTACT NUMBER: HEIGHT: WEIGHT BLOOB TYPE: RELIGION:
( FEET ) ( KGS )
09270217301 5’8 70kg A+
CONTACT PERSON IN CASE OF EMERGENCY: CONTACT NO.:
Caroline Joyce Aldana 09163014372
BIRTH DATE: BIRTH PLACE:
May 22, 1993 Tacloban City, Leyte
GSIS/SSS: PHILHEALTH: PAG-IBIG: TIN NO.
35-1745002-7 13-251462664-6 121295451241 -
CLUB AFFILIATION: REGION:
MAPITAGAN LAGUNA EAGLES Club NCR XXIV - MAPITAGAN
CLUB PRESIDENT EY 2022: MEMBER CONTROL NO.
Eagle GERARD S. BULAO

CLUB PRESIDENT SIGNATURE LATEST 2X2 PHOTO EAGLE MEMBER SIGNATURE

Eagle BOBBY O. UMANGA


CLUB MEMBERSHIP CHAIRMAN (SIGNATURE) REGIONAL GOVERNOR E.Y. 2022 (SIGNATURE)

Eagle ALEXANDER T. ALAG Eagle NELSON ALONTO SARAPUDDIN


EXECUTIVE PEIL DIRECTOR, E.Y. 2021-2022 NATIONAL PRESIDENT E.Y. 2021-2022
(SIGNATURE) (SIGNATURE)

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