YOUTH EMPOWERMENT: THE SOLUTION (YES!

)
Membership Application Form
2022-2023
Personal Information
Complete Name Catalan Gland Marie Pacarro
(Last Name) (First Name) (Middle Name)

Nickname Marie

Home Address Migpange, Bonifacio Misamis Occidental

Birthday July 6, 1999 Sex Female

Religion Roman Catholic Civil Status Single

Mobile Number 09683020420 FB account Marie Dee Catalan

Email address glandmariecatalan@gmail.com

School Governor Alfonso D. Tan College Program BSBA HRM

Guardian Information
Guardian 1 Guardian 2
Last Name Catalan Last Name Catalan(Deceased)
Name Jerly Name Rodrigo

Mobile Number 09381425386 Mobile Number (Deceased)

Occupation housewife Occupation (Deceased)

What are your Hobbies, Interests, Talents and Fun Facts about you!
wriľe on ľhe back if you have more ľo wriľe

Hobbies is the activities we take part in to meet new people. Hobbies also help
us bond with friends and family. Hobbies is ways to express yourself in your
current interest and activities. One of my favorite is gardening. Gardening is
fun and relaxing. It can even be a good form of exercise. Gardening can be a
great way to get your mind off the cares of this world.

I hereby certify that the information written above is true and complete to the best of my knowledge. I
hereby authorize YES! to investigate all statements made in this application, and to gather information about
myself that will be used for the sole purpose of evaluation. I confirm further that my signature indicates my
commitment and support to the vision and mission of YES Movement.

MEMBERSHIP ID NO. (to be filled by a YES Officer)

Jenie Rose D. Soriano
Signature over Printed Name