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MEMBERSHI

P
MEMBERSHIP FORM

Date Filled: May 05, 2017


Amount: USD 20.00 (Non-Filipino Citizens)
PhP 500.00 (Filipino Citizens)

PERSONAL INFORMATION

Name: Rex A. Lim Email: rockmekoyace2013@gmail.com


Contact No: 09177270299 Country of Residence: Philippines
Address: #53 V. Mapa Street, Tionko Avenue, Davao City, Philippines, 8000
Organization/School/University: Davao City National High School, Senior High School Program
Vice President for Research/Research Director:
____________________________________________________
Contact No: ___________________________________________________
Email Address: ___________________________________________________

EDUCATIONAL BACKGROUND
Bachelors Degree: Bachelor of Secondary Education
Major: English
Masters Degree: Master of Education in Language Teaching
Major: English
Doctoral Degree: Doctor of Philosophy in Education major in Applied Linguistics (on-
going)

Please fill-out the form, scan, and send to astr.2015ph@gmail.com. You may also
personally return the filled-out form to any personnel of ASTR.

ASTR BANK ACCOUNT


Name of Bank: Bank of the Philippine Islands
Address: Georgetown Cybermall, Cagayan de Oro City, Philippines
Account Name: Asian Society of Teachers for Research Inc
Account Number: 8991-0004-62 (PESO SAVINGS ACCOUNT)

SEC REG. NO. CN201619200

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