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  • A4-MEMBERSHIP FORM-revised

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    Shikarin Kita
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    This document contains personal information and designates beneficiaries for a member of the PNP Non-Uniformed Personnel Association (NUPAI). It lists the member's name, address, contact details, and employment information. It also outlines the association fees of P100 one-time membership fee and P50 monthly dues. Finally, it designates the member's beneficiaries for the association's welfare program by name, relationship, and age.

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    This document contains personal information and designates beneficiaries for a member of the PNP Non-Uniformed Personnel Association (NUPAI). It lists the member's name, address, contact details, and employment information. It also outlines the association fees of P100 one-time membership fee and P50 monthly dues. Finally, it designates the member's beneficiaries for the association's welfare program by name, relationship, and age.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Download as pdf or txt
    34 views1 page

    A4-MEMBERSHIP FORM-revised

    Uploaded by

    Shikarin Kita
    This document contains personal information and designates beneficiaries for a member of the PNP Non-Uniformed Personnel Association (NUPAI). It lists the member's name, address, contact details, and employment information. It also outlines the association fees of P100 one-time membership fee and P50 monthly dues. Finally, it designates the member's beneficiaries for the association's welfare program by name, relationship, and age.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    PERSONAL INFORMATION 1X1 ID Picture

    DESIGNATED BENEFICIARIES
    In connection with my obligation as member of
    the PNP Non-Uniformed Personnel Association, This is to attest that the undersigned PNP
    FIRST NAME: ____________________________________________ Inc. (NUPAI), I agree to pay the following NUPAI-____________ Chapter member is
    MIDDLE NAME: __________________________________________ association fees, as indicated below: designating the following persons as his/her
    LAST NAME: _____________________________________________ beneficiaries in the association’s welfare
    1. Membership fee – P100.00 one-time program (listed according to priority)
    ADDRESS: ______________________________________________
    cash payment for members. (MF goes
    _______________________________________________________
    directly to the general fund)
    NAME RELATIONSHIP AGE
    TEL. NO. /CP No. _________________________________________

    EMAIL ADD: _____________________________________________ 2. Monthly dues – P50.00 (P30 goes to the


    NUPAI Chapter Fund and P20 goes to
    BIRTHDATE: _____________________________________________
    Bereavement Assistance Program)
    CIVIL STATUS: ___________SEX: ______ RELIGION:_____________

    EDUCATIONAL ATTAINMENT:
    _________________________________________________
    FOR: Finance Service
    OFFICE/UNIT: _____________________________________

    POSITION: ________________________________________ I hereby authorize the PNP Finance Service to


    ______________________________
    deduct from my salary the monthly dues as
    SKILLS/HOBBIES: __________________________________ Signature over Printed Name
    indicated above and to remit the same to the
    EMPLOYMENT STATUS: PERMANENT MOA/COS
    PNP NUPAI – __________________________ ________________________________
    CASUAL/CONTRACTUAL
    TEMPORARY Chapter. Date
    COMMITTEE/S I WANT TO JOIN:

    Membership
    Discipline/Grievance _______________________________________
    Labor Education and Research PNP NON-UNIFORMED PERSONNEL ASSOCIATION, INC.
    Signature over Printed Name (NUPAI)
    Ways and Means
    Morale & Welfare
    ______________________________________ Camp BGen Rafael T. Crame, Quezon City
    Date Email: pnpnupai@gmail.com
    Signature and Date (mm/dd/yyyy)

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