PHILIPPINE LIBRARIANS ASSOCIATION, INC.

(PLAI)
Member, International Federation of Library Associations and Institutions (IFLA)
Member, Congress of Southeast Asian Librarians (CONSAL)
PLAI Headquarters, Rm. 301, 3/F, The National Library of the Philippines Building
T.M. Kalaw St., Ermita, Manila 1000, Philippines
Mobile: 0998 992 2267 | www.plai.org.ph | nbot@plai.org.ph, plainbot2017@gmail.com

FOR THE TREASURER:

Membership Fee: P800.00*
PLAI OR No. : ________________
*P500 for membership fee + P300 membership due for the year
of application
Renewal/Annual dues: P300.00 per year

REGIONAL COUNCIL: ____________________________________________________________

NAME: ___________________________________________________________________________________
SURNAME FIRSTNAME MIDDLE NAME

HOME ADDRESS: ______________________________________________________________________

EMPLOYER: ______________________________________________________________________

ADDRESS: ______________________________________________________________________

PHONE: _______________________

FAX: _______________________

EMAIL: _______________________

MOBILE: _______________________

PRESENT POSITION/DESIGNATION: ___________________________________________________

PRC LICENSE: _______________________

EXPIRATION DATE: _______________________

DATE OF PAYMENT: _______________________

MODE OF PAYMENT (Cash/Check/Bank Deposit): _______________________

• Accomplish this form and send it together with a copy of the deposit slip, with your name
written on it, to plainbot2017@gmail.com

• Payment maybe be deposited to:

Bank Name: BDO
Account Number: 451 000 1102
Account Name: Philippine Librarians Association, Inc.

Any information provided in this form will be used solely for the purpose of updating the membership
record.