Association

+63 2 805 2098 * +63 908 962 3452 * kakkampi@gmail.com

1. Family name First name Nick name Maiden name

2. Date of birth 3. Place of birth 4. Nationality at birth 5. Present nationality 6. Sex

7. Height 8. Weight 9. Marital Status

Single [ ] Married [ ] Separated [ ] Widower [ ] Divorced [ ]
10. Membership into KAKKAMPI might entail travel outside Switzerland to represent the association in Meetings and Conferences.
Can you travel outside Switzerland? YES [ ] NO [ ]

11. Address in Philippines 12. Address in Switzerland 13. Phone no. in Philippines

14. Phone no. in Switzerland

15. Email

16. Have you any dependants? If yes, please provide following information:
Name Age Relationship Name Age Relationship

17. KNOWLEDGE OF LANGUAGES.

LANGUAGES READ WRITE SPEAK UNDERSTAND
Easily Not easily Easily Not easily Fluently Not fluently Easily Not easily

18. EDUCATION
Years attended
Name place and country Degrees and academic distinctions Certificates or diplomas obtained
from to

19. OTHER SKILLS (e.g. Typing, Drawing, Writing, Driving, Cooking, Baking, …)

20. MEMBERSHIP TO OTHER ASSOCIATIONS

Name of Association Position Since when

21. K-GROUP MEMBERSHIP

Name of K-Group:
Date Joined:
Home Office:

Signature Date