PARTICIPATION FORM

POEM WRITING CONTEST

DISTRICT DATE

CONTACT
COORDINATOR NUMBER /
(NAME) TELEGRAM
NUMBER

GROUP MEMBERS
GROUP OCCUPATION /
FULL NAME GENDER AG CATEGORY LOCAL CONTACT NUMBER /
# NAME TUNGKULIN ACADEMIC
E (IF DUET, TRIO & CONGREGATION TELEGRAM NUMBER
GIVEN NAME MIDDLE NAME SURNAME M F SOLO DUET TRIO QUARTET
QUARTET) LEVEL
1
2
3
4
5
6
7
8
9
10
CERTIFICATION ON MEMBERSHIP
Remarks

CFO BUKLOD DISTRICT PRESIDENT CFO DISTRICT OVERSEER DISTRICT SUPERVISING MINISTER
(Signature over printed name) (Signature over printed name) (Signature over printed name)