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CLUB MEMBERSHIP FORM

NAME OF THE CLUB: MAPEH CLUB

Name of Student : ________________________________________

Mobile Number: ________________________________________

Address: ________________________________________ Passport Size

Grade: ________________________________________

Birthdate: ________________________________________

Age: ________________________________________

Sex: ________________________________________

Skills: ________________________________________

In Case of Emergency Please Contact

Name of Parent? Guardian: _____________________________________

Address : _____________________________________

Contact Number : _____________________________________

___________________________ _______________________________

Name and Signature of Member Name and Signature of Parent/ Guardian

Noted:

___________________________

Club President

AILYN T. BERNAL

Club Adviser

APPROVED:

ARVIN T. GARSUTA

School Head/ Overall Chairperson

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