Republic of the Philippines

Department of Education
Region III
DIVISION OF CABANATUAN CITY
District VI
SAN ISIDRO INTEGRATED SCHOOL
San Isidro, Cabanatuan City

MEMBERSHIP FORM
SIIS DANCE COMPANY

A. STUDENT INFORMATION:

Name: _____________________________________ Sex: ______

Last Name First Name M.I

Date of Birth:_____________ Age: ______ Place of Birth: ____________

(mm/dd/yy)

Home Address: ______________________ Email Address: _____________

Facebook Name: ___________ CP#:___________ Grade&Sec: ________

B. PARENT INFORMATION:

Name of Father: ____________________________ CP#:______________

Last Name First Name M.I

Name of Mother: ____________________________ CP#:______________

Last Name First Name M.I

C. GENERAL INFORMATION:

▪ Although not required. Do you have any dance experience? ____________________

▪ Where and how long? __________________________________________________
▪ What genre of dance you most liked? _____________________________________
▪ What is your preferred time for the training? ________________________________

▪ What are your expectations of this Dance Organization?

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School: San Isidro Integrated School

Address: Purok 4, San Isidro, Cabanatuan City, 3100
E-mail: 500735@deped.gov.ph