Phaltra Bldg. Bo. 139 Matahimik St., UP Village, Q.C.

, Metro Manila, Philippines

APPLICATION FOR REGULAR MEMBERSHIP

FELLOW PRACTITIONERS:
I, ______________________________________________ hereby apply for membership into the Philippine
Institute of Real Estate Service Practitioners (PhilRES) Incorporated and be accepted as a Regular Member.
I HEREBY PLEDGE to comply with the Constitution and By Laws of the PhilRES as part of the conditions of my
application into PhilRES as a Regular Member.
I AM WILLING TO COMPLY with all the requirements and pay all fees and assessments as maybe necessary for
my application into the PhilRES as a Regular Member.
ATTACHED PLEASE FIND my fully accomplished Members Personal Data Sheet and a photocopy of my valid
PRC license/s ID / Certificate/s of Registration or PRC Receipt No. _________ issued on _________ , ___, 20___
as well as Certificate of Registration and Identification Card Claim Slip.

Very truly yours,

_______________________________________
Full Name (print legibly)

__________________________
Signature and Date

Passport size
PHOTO
preferably with
name tag

PRC License issued at PRC Office: _______________________________

[ ] Real Estate Consultant # ___________________

Registration Date: ________________

[ ] Real Estate Appraiser # ___________________Registration Date:

________________

[ ] Real Estate Assessor # ___________________

Registration Date: ________________

[ ] Real Estate Broker # _____________________

Registration Date: ________________

Contact Information:
Telephone #s : ________________________
Celphone #s

: ________________________
________________________

E-mail Address : ______________________

Facebook : __________________________
Website :

___________________________

Residential Address:
___________________________________ City/Municipality: ________________ Province: ________________
Office Address:
___________________________________ City/Municipality: ________________ Province: ________________

PhilRES (AIPO) Membership No.

as required under Sec. 34 & 38, IRR of RA 9646