Cebu Normal University

Republic of the Philippines

Osmeña Boulevard, Cebu City
College of Arts and Sciences

POLIKRATOS
MEMBERSHIP PROFILE

(Fill out the form in print) (for contact purpose) YEAR LEVEL____ Male___ Female___
Name: _________________________________________________ Birthdate:________________
Prov. Address: __________________________________________ Age______
City Add. ______________________________________________ Height_____ Weight______
How often do you go home (if boarding): _____________________ (for pageant purpose)
Contact Numbers: ________________________________________ Medical considerations:
Email Address: __________________________________________ _______________________
Daily Allowance: Php______ from parents___ from part work____
If Working Student, where? : _______________________________
(daily allowance will let us assess how much contribution we may impose) (for schedule purpose)
(for tracking-you-down purpose) (Indicate SUBJECT and ROOM) TRUE / FALSE
TIME SCHEDULE MONDAY / WEDNESDAY TUESDAY / THURSDAY I like my schedule:
7:30am– 9:00am T___ F___
9:00am – 10:30am I am willing to come
10:30am -12:00nn on Fridays:
12:00nn – 1:30pm T___ F___
Preferable days of
1:30pm – 3:00pm
activity: FRI_____
3:00pm – 4:30pm
SAT___SUN____
4:30pm – 6:00pm
6:00pm – 7:30pm
Top 3 of your Achievements Skills / Talents (something very unique)
(Academics/athletics/competitions, etc) _____________________________________________
1 __________________________
2 __________________________ I can: (check as many as possible)
3 __________________________ ___ sing ___ design stage
___ dance ___ manipulate sound system
Top 3 positions you held ___ emcee ___ design booths
(If none, past memberships) ___ orate ___ choreograph dance moves
1 _________________________ ___ debate ___ play musical instrument/s
2 _________________________ ___ model ___ coach athletics
3 _________________________ ___ act ___ join pageant

I have (resources) : Suggestions, comments, violent reaction

___ PC at home _________________________________
___ laptop (I can bring it in CNU) _________________________________
___ internet connection (I can surf, research) _________________________________
___ digital camera (I can document) _________________________________
___ large speakers _________________________________

I can stay in CNU until 10pm (yes/no, reason) _________________________________________

Things I LIKE about joining in a club ________________________________________________

Things I HATE about joining a club _________________________________________________

If only you were the Prime Minister of POLIKRATOS, what will do or impose?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

If (and only if) you are shy, no time, no talent, no interest, how will POLIKRATOS benefit from you?
______________________________________________________________________
(Complete the sentence) POLIKRATOS is ___________________________________