The Palo Rah Rah Rousers Inc.

Application Form

Name: ____________________________ Date of Birth: ________ Sex: ______

(Surname, First Name)

Permanent Address: _____________________________________________

School/Occupation: ______________________________
Contact Number: __________________
Groups/Organization: ___________________________________________
(Musical or Otherwise currently affiliated)

Level of Expertise: Beginner Intermediate Advance

Favorite Singer/Group: _________________________________
Emergency Contact: _______________________________________________
(Include Name of persons, Contact, Example: Ferdinand Joseph Gernale (Father) – 0906******* )

Facebook Account: ________________________

The Palo Rah Rah Rousers Inc.

Application Form

Name: ____________________________ Date of Birth: ________ Sex: ______

(Surname, First Name)

Permanent Address: _____________________________________________

School/Occupation: ______________________________
Contact Number: __________________
Groups/Organization: ___________________________________________
(Musical or Otherwise currently affiliated)

Level of Expertise: Beginner Intermediate Advance

Favorite Singer/Group: _________________________________
Emergency Contact: _______________________________________________
(Include Name of persons, Contact, Example: Ferdinand Joseph Gernale (Father) – 0906******* )

Facebook Account: ________________________