TAGURANAO WATER SERVICE COOPERATIVE

Taguranao, Tubod, Lanao Del Norte

APLLICATION FOR MEMBERSHIP AND SUBSCRIPTION AGREEMENT

I hereby apply for membership of Taguranao Water Service Cooperative, Taguranao, Tubod,
Lanao Del Norte and agree faithfully obey its rules and regulations as set down in its By – Laws,
amendments and decisions of the general memberships meetings as well as all those of the board of
directors.

I have paid the required membership fee of ____________.

I also, hereby pledge to subscribe initially for ____________ share/shares as my initial paid up
capital. The balance of my subscription, I promise to pay it in (weekly/semi –
monthly/monthly/quarterly/semi-annually) ________ installment of P__________.

__________________________________

Signature Over Printed Name of Applicant

MEMBERSHIP PROFILE:

Address: __________________________________________________________________

Date of Birth: _________________________ Age: ____________

Gender: _________ Civil Status: __________ Occupation: _______________

Spouse: ____________________________________________

Number of Dependents: _____________________________

INFORMATION OF MEMBERSHIP UPON ACCEPTANCE

Name of Member: ___________________________________________________

Membership Cel. Number: _____________________________ TIN #: _________________________

a.) Date Accepted : __________________ BOD Resolution #: _____________

b.) Type/kind of Membership: _______________________
c.) Initial Capital Subscription : ________________________
d.) Number of Shares: _______________________________
e.) Initial Capital Build Up: ___________________________

Reference: 1_________________________________ 2. _____________________________________