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REGISTRATION OF LEADERS
POSITION T/NT REG. STATUS NAME (Last, First, M.I.) BIRTHDATE BENEFICIARY
Troop Leader OLD NEW
Co-Leader
REGISTRATION OF TROOP MEMBERS
NAME Birth date Gr./Yr Reg. Status BENEFICIARY
(Last Name, First Name, M.I.) MM DD YY Re-Reg. New
Name of Patrol/Cluster
1
2
3
4
5
6
7
8
Name of Patrol/Cluster
1
2
3
4
5
6
7
8
Name of Patrol/Cluster
1
2
3
4
5
6
7
8
Name of Patrol/Cluster
1
2
3
4
5
6
7
8
Name of Patrol/Cluster
1
2
3
4
5
6
7
8
Submitted By: Noted By:
___ _VI_______Region
____ILOILO____Council
___ _VI_______Region
____ILOILO____Council