GIRL SCOUTS OF THE PHILIPPINES

NATIONAL HEADQUARTERS
901 Padre Faura St., Ermita, 1000 Manila

BARANGAY COMMITTEE REGISTRATION FORM

Visayas Region
___________
Bohol
___________ Council

Barangay Committee Name: ______________________ District Committee Number: ___________________

Barangay Committee Address: ____________________ District Committee Address: ___________________

Tel. No.: ______________________________________ Tel. No.: ___________________________________

Registration Status: Re-reg New

POSITION NAME BIRTHDATE REG. STATUS BENEFICIARY

(Last Name, First Name, MI) (MM/DD/YY) Re-reg New
Chairman
Vice-Chairman
Secretary
Treasurer
Member
Member
Member
Member
Member
Member
Member
Member
Submitted by: Processed by:

__________________________ ___________ ____________________ _____________

BC Chairman Date Registration Processor Date

COUNCIL REMITTANCE
Approved by:
Members : ___ Re-reg. ___ New ...................... P _________
Program Dev’t Fund .......................................... P _________
Contribution to the Mutual Assistance Fund P _________ ____________________ _____________
Total Remittance .................................. P _________ Council Executive Date

B.C. Group Fee (To be retained by Council) ...... P _________

Paid under R.O.R. No. ________ Date __________
DCCR No. _________ Date of Deposit __________

No. of Cards Issued: From ___________ to ____________

ID Card Series Year: __________