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NOTE: Please fill-up all the information and send it back to PCLS by fax or e-mail.
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Type of Membership
Membership Dues
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| APPLICANT INFORMATION | |||
Name: |
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Telephone Number: |
Office: | ||
Mobile: |
E-mail: | ||
Date of Birth: |
Civil Status: | ||
Current Address: |
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City: |
Country: | ZIP Code: | |
I have the following number of cats: |
Pedigree: | Non-Ped/HHP: | |
| MEMBER REFERENCES | |||
Name |
Address | Phone/E-mail | |
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| NON-MEMBER REFERENCES | |||
Name |
Address | Phone/E-mail | |
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| FOR CLUB USE ONLY | |||
Committee approval: |
Date: | ||
Payment amount: |
Received by/Date: | PR/OR: | |
Membership #: |
Issued by: | Valid until: | |
| SIGNATURES | |||
By affixing my signature below, I hereby signify my intention to become an associate member of Philippine Cat Lover's Society and therefore abide by the rules and regulations set forth in its constitution and by-laws. I understand that associate membership does not have voting privileges and acceptance into regular membership is governed by the terms in the club's constitution. I also hereby certify that the information contained in this form is true and correct to the best of my knowledge and any misrepresentation can render my application invalid. |
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Signature of applicant: |
Date: | ||
Signature of guardian (for applicants under 18 years of age): |
Date: | ||
Form AMAF-2006-07, v1 rev00 |
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