PARTIDO DEMOKRATIKO

PILIPINO
LAKAS NG BAYAN
(PDP

LABAN)
Please

MEMBERS DATA SHEET

submit two
copies of
your 1x1 ID

Please write down clearly. Mark appropriate boxes with or .

ID Number (O.R. Number)

Date of BMS

First Name

Gender

Place of BMS

Middle Name

Nickname

Telephone Number

Male

Age

picture.

Date of Birth

Email Address
Name of Spouse, if married

Place of Birth
Street / Purok No.

Barangay

Suffix

Cell Phone Number

Civil Status

Female

House No. / Lot No. / Block No.

Last Name

Religion
Subdivision / Sitio / Neighborhood

City / Municipality

Province

District

Educational Attainment

Profession / Occupation / Sector

Name of School/Level/Degree:

Elected Official/Position:_____________________

Govt Employee

Entrepreneur

Self-employed

Year Graduated:

Cooperative / NGO

Private Employee
Unemployed
Other:_______________
Membership/Involvement/Employment with other Organizations/Companies/Agencies

Organization / Company / Agency

Person to be notified in case of emergency

Designation

Year Joined / Term

Contract Number

R O O M 4 0 4 , 4 T H F L O O R , B E L - A I R A PA RT M E N T , 1 0 2 0 R OX A S B LV D . , E R M I TA , M A N I L A
(02)354-9010 / (02)358-8813 pdplaban.nhq@gmail.com / pdplaban.roxasblvd@gmail.com

partidoPDPLABAN

PARTIDO DEMOKRATIKO
PILIPINO
LAKAS NG BAYAN
(PDP

LABAN)

___________________________________________________
Name of Member & Signature
(Please sign over printed name)
Recruited by:

Conducted by:

One Time Membership Fee

Amount Paid:

____________________________
Chapter Head/Coordinator
(Please sign over printed name)

____________________________
Party Trainor
(Please sign over printed name)

Database Entry
Encoder:

O.R. No.
Date Issued

Date:

R O O M 4 0 4 , 4 T H F L O O R , B E L - A I R A PA RT M E N T , 1 0 2 0 R OX A S B LV D . , E R M I TA , M A N I L A
(02)354-9010 / (02)358-8813 pdplaban.nhq@gmail.com / pdplaban.roxasblvd@gmail.com

partidoPDPLABAN

PARTIDO DEMOKRATIKO
PILIPINO
LAKAS NG BAYAN
(PDP

LABAN)

PANUNUMPA
Ako, si ________________________________________________________________________
ng ________________________________________________________________________ lungsod
ng

________________________________________________________________________

na

tinanggap bilang kasapi ng PARTIDO DEMOKRATIKO PILIPINO LAKAS NG BAYAN (PDP

LABAN) ay sumusumpa na:

itataguyod ko ang Saligang Batas ng Partido na kung

saan nakalahad ang aking paniniwala at paninindigan
para

sa

Kalayaan,

Pagkakaisa,

Pagkakapantay-pantay

at

Kasarinlan,

Pagkilos,

Mabisang

Katarungan,

Pananagutang

Panlipunan,

Pagkamakabayan

at

Pederalismo;

susundin

ko

ang

mga

alituntunin

at

patakarang

ipatutupad ng mga kinauukulang pamunuan ng Partido;

itataguyod ko at makikiisa sa mga pagkilos ng Partido;

iaalay

ko

ang

aking

sarili

sa

masalimuot

ngunit

kinakailangang tungkulin para sa ikauunlad ng bawat

mamamayang Pilipino at sa Kalayaan ng Bayan.
Lahat ng ito ay aking tinanggap ng kusang-loob at walang pasubali.
KASIHAN NAWA AKO NG MAYKAPAL.

R O O M 4 0 4 , 4 T H F L O O R , B E L - A I R A PA RT M E N T , 1 0 2 0 R OX A S B LV D . , E R M I TA , M A N I L A
(02)354-9010 / (02)358-8813 pdplaban.nhq@gmail.com / pdplaban.roxasblvd@gmail.com

partidoPDPLABAN

PARTIDO DEMOKRATIKO
PILIPINO
LAKAS NG BAYAN
(PDP

LABAN)

Nilagdaan ngayong ika-_____ ng ______________________________ taon _____.

_________________________
Lagda ng Kasapi
Pinagtibay:
_________________________
Lagda ng Pinuno

R O O M 4 0 4 , 4 T H F L O O R , B E L - A I R A PA RT M E N T , 1 0 2 0 R OX A S B LV D . , E R M I TA , M A N I L A
(02)354-9010 / (02)358-8813 pdplaban.nhq@gmail.com / pdplaban.roxasblvd@gmail.com

partidoPDPLABAN