Membership Form of CDP

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Centrist Democratic Party of the Philippines (CDP)

Unit 3, 2nd F MILLE Building, 335-337 Gil Puyat Ave. (formerly Buendia) cor. Dominga St., Pasay City Landline/Fax No. (+632) 799 4924 Mobile Numbers: 09276567528(Globe) ; 09287498674(Smart) Website: www.cdp.ph ; Email Address: [email protected]

Membership Form
All members of the Centrist Democratic Party of the Philippines (CDP) are required to complete this membership form and return via email to [email protected] / [email protected] or fax it to the National Secretariat. Please indicate your payment method.

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SECTION 1: MEMBERS ADDRESS


REGION: MUN./CITY: HOUSE #: CURRENT ADDRESS/ PLACE OF ORIGIN: (House #) (Street) (Barangay) (City/Mun.) (Province) ST.: PROVINCE: BRGY: POSTAL CODE: DISTRICT:

SECTION 2: MEMBERS PERSONAL INFORMATION


TITLE LAST NAME: GENDER: MALE FEMALE LGBT Mr. Mrs. Miss Ms. FIRST NAME: BIRTHDATE (MM-DD-YYYY): Other, specify: MI:

SECTION 3: MEMBERS CONTACT INFORMATION


AREA CODE: LANDLINE #: FAX #: MOBILE #: PRIMARY EMAIL: SECONDARY EMAIL:

SECTION 4: MEMBERSHIP TYPE AND PAYMENT DETAILS


MEMBER TYPE CORE VOLUNTEER PAYMENT METHOD AR/OR NUMBER: DATE OF B.O.S. ATTENDED: DESCRIPTION
Core membership is open for all those interested and who are willing to pay the membership fee, abide by the party ideology, principles and guidelines and can actively participate in the partys endeavors. Volunteer membership is open for all those interested and who are willing to abide by the party ideology, principles and guidelines and can actively participate in the partys endeavors.

MEMBERSHIP DUES PHP 10001 PHP 0.00

Please Check

Cash

Cheque

Other:

AMOUNT OF PAYMENT: DATE OF PAYMENT: SPEAKER OF THE B.O.S:

SECTION 5: OTHER INFORMATION


EDUCATIONAL ATTAINMENT: OCCUPATION /JOB TITLE: AFFILIATION: ADDRESS OF AFFILIATED INSTITUTION/ORGANIZATION: CONTACT INFORMATION OF AFFILIATED INSTITUTION/ORGANIZATION: AREAS OF PROFESSIONAL INTERESTS: ELEMENTARY SECONDARY UNDERGRADUATE GRADUATE

SECTION 6: DECLARATION
I hereby solemnly swear that I will uphold and advance the principles, objectives and programs of action of the Centrist Democratic Party of the Philippines, abide by its Constitution and By-Laws and policies, and fight for its interests as I also uphold the interests of my country and people. It is also my utmost regard to help prevent patronage politics in the Party.
SIGNED (and write name here) DATE:

The information provided above will also be used to keep you informed about the Centrist Democratic Party of the Philippines Regions events in future.

Valid for one (1) year: Php 1,000.00 one-time payment / Php 500.00 per semester.

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