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MMGEC - Membership Application Form R8 Gideons v2

The document is a membership application form for the Fraternal Order of Eagles (Philippine Eagles), a fraternal socio-civic organization. The application requests personal information such as name, date of birth, address, employment details, education history, and contact information from applicants. It also requires applicants to list any legal dependents and provide details on hobbies and special skills. At the bottom, portions are designated for endorsement and approval by current members and leadership of the organization.

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AYSA GENEVIERE O.LAPUZ
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97 views1 page

MMGEC - Membership Application Form R8 Gideons v2

The document is a membership application form for the Fraternal Order of Eagles (Philippine Eagles), a fraternal socio-civic organization. The application requests personal information such as name, date of birth, address, employment details, education history, and contact information from applicants. It also requires applicants to list any legal dependents and provide details on hobbies and special skills. At the bottom, portions are designated for endorsement and approval by current members and leadership of the organization.

Uploaded by

AYSA GENEVIERE O.LAPUZ
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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THE FRATERNAL ORDER OF Eagles

(Philippine Eagles)
First Philippine Born Fraternal Socio-Civic Organization
“Service Through Strong Brotherhood”

PHILIPPINE EAGLES INSTITUTE OF LEADERSHIP


Manila Matikas Gideons Eagles Club
MEMBERSHIP APPLICATION FORM
PERSONAL INFORMATION:
NAME
GILBERT BERT DELACRUZ LAPUZ
FIRST NAME (NICKNAME) MIDDLE LAST NAME
CIVIL STATUS
PLACE OF BIRTH SAN PEDRO, STA.ANA PAMPANGA
DATE OF BIRTH SEPTEMBER 14,1984 SINGLE MARRIED

HEIGHT 5’10” WEIGHT 92 kgs. SEPARATED WIDOW/ER

CITIZENSHIP Filipino RELIGION Catholic BLOOD TYPE O

ADDRESS
1465 ULI ULI ST. BARANGAY 639 SAN MIGUEL, MANILA NCR
STREET NO. BARANGAY MUNICIPALITY/CITY PROVINCE ZIP CODE

TELEPHONE NO. CELLPHONE NO. 09167347280 EMAIL [email protected]

EMPLOYMENT / PROFESSION:
NAME OF OFFICE POLYTECH CONS.DEVELOPMENT ADDRESS CUBAO, QUEZON CITY
LINE OF BUSINESS CORPORATION
TITLE AND POSITION ELECTRICIAN TEL. NO. FAX NO.

LIST OF LEGAL DEPENDENTS:


NAME DATE OF BIRTH AGE
SPOUSE NAME AYSA GENEVIERE O. LAPUZ AUGUST 30,1973 48
NAME 1. JED CHRISTIAN O. LAPUZ NOVEMBER 28.2009 12
OF 2. KASSANDRA O. LAPUZ AUGUST 12,2015 7
C 3.
H
I
L 4.
D
R 5.
E
N 6.

EDUCATIONAL ATTAINMENT:
SAN JUAN SAN PEDRO ELEMENTARY SCHOOL
ELEMENTARY DATE GRADUATED 1996
PAMPANGA
HIGH SCHOOL SAN ISIDRO HS PAMPANGA DATE GRADUATED 2000
COLLEGE DON HONORIO VOCATIONAL SCHOOL DATE GRADUATED 2002
COURSE ELECTRICIAN
HOBBIES
SPECIAL SKILLS DRIVING
SPONSOR: (Regular Member of the Club)
NAME DATE SIGNATURE

Eagle
APPLICANT’S SIGNATURE
ENDORSED BY:

Eagle HERBERT S. DAYON Eagle JERICO S. DE GUZMAN


REGIONAL GOVERNOR, NCR - XXII EY 2022
CONCURRED BY: APPROVED BY:

Eagle ALEXANDER T. ALAG Eagle NELSON ALONTO SARAPUDDIN


EXECUTIVE PEIL DIRECTOR EY 2021 - 2022 NATIONAL PRESIDENT EY 2021 - 2022

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