BIBLE READERS SOCIETY INTERNATIONAL

“Leading the People in Reading the Bible”

3353-D R. Magsaysay Blvd., Sta. Mesa, Manila / breadsocietyi@yahoo.com / (02)716-4590

PERSONAL INFORMATION

LAST NAME FIRST NAME MIDDLE NAME

Present Address: Tel. #

Provincial Address Tel. #

Age: Date of Birth: / / Place of Birth: Gender: Blood Type:

Citizenship: Height: Weight: Civil Status: Religion:

Messenger Add: Email Add: Mobile #:

Name of Mother: Tel. #

Name of Father: Tel. #

Person to Notify in Case of Emergency: Relationship:

Address: Tel. #

ORGANIZATIONAL BACKGROUND

Date of Affiliation: / / Chapter:

Sector/ District: Division:

Means of Affiliation: ___ Regular BSF ___ BSF Express ___ Orientation

Current Membership Status: ___ Regular ___ Honorary ___ Alumni ___ Speaker

Membership Classification: ___ Member ___ Officer

Level / Position / Department:

EDUCATIONAL BACKGROUND
College / Tertiary Level

Course: Year Graduated:

Type: Vocational Bachelor's Degree Level: ____Graduate ____Undergraduate

Graduate Studies:

Course:

Secondary Level: Year Graduated:

Primary / Elementary Level: Year Graduated:

PREFERENCES
Dialects Spoken:

Skills: Talents

Technical: Writing Computer Literacy Singing Dancing Acting Public Speaking

Others: Others:

Industrial: Drafting Electronics Hobbies:

Others:

Committee: ___ Choir ___ Artist Guild ____ Theatre ___ Marketing ___ Research ___ Print Media

Department you want to be involved with:

Interests:
 WORKING EXPERIENCE
Position Company Nature of Work Year Covered

SEMINARS ATTENDED
Title Venue Speaker Date

AFFILIATIONS

Political Affiliation

Name Position Jurisdiction

Organizational Affiliation

Organization Name Current Position Date of Affiliation

CHARACTER REFERENCE

BREAD Members

Name Position Chapter Contact #

Non-BREAD Members

Name Position/Company Address Contact #

I hereby certify that the above information is true and correct, and hereby authorize the organization to verify said information.

Date Signature

To be filled up by the HRD Registration Staff

Date Filed: / / Registration Officer: Position:

ID Application Details

KaBREAD Number: -- --