Capitol Savings & Loans Cooperative (CASALCO)

Corrales Extension, Cagayan de Oro City

Dear Cooperator;
MEDOCARE is now available through CASALCO with only P_888.03_ amortization per quincena under PRIVATE
with a maximum benefit limit of P 100,000.00 per illness, with Annual Physical Examination. If you are interested
please fill-up thee confirmation slip and submit to our office subject for verification and approval. For more information
please call or contact 0915-580-3508 or Casalco Group FB: Capitol cooperative and email:
Casalcocooperative@gmail.com
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CONFIRMATION SLIP
I would like to apply/renew for a Health Insurance in your office. Payment is authorized for salary deduction.
Complete Name:_________________________________________________ Date: __________________
Address:__________________________________________________________________________________
Birthdate:_______________ Age:____ Gender:_____ Status:____________ Phone No._________________
Name of company Employed:____________________________________ Position:_____________________
Name of Beneficiary:________________________________ Birthdate of Beneficiary:____________________
Relationship to Beneficiary:______________________ Phone Number of Beneficiary:____________________
Printed Name & signature:______________________________
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