REPUBLIC OF THE PHILIPPINES ) S.S.

 
___________________________ CITY ) 
 
 
SWORN APPLICATION TO CONDUCT  
MEMBERSHIP RECRUITMENT AND APPLICATION PROCESS 
 
We,  __________________________________________________________    ,  Filipino 
citizens,  of  legal  age,  with  address  c/o  Ateneo  de  Manila  University,  Loyola  Heights, 
Katipunan Ave., Quezon City, state under oath that: 
 
1. We  are  the  duly  elected  Student  Head  and  Moderator,  respectively,  of    Musmos 
Ateneo for School Year 2020 -2021 . 
 
2. In  compliance  with  the  ​Guidelines  for  Membership  Application  and  Recruitment 
Process  for  Registered  Student  Organizations  ​set  by  the  Loyola  Schools  Office  of 
Student Activities, we hereby submit as Annex “A” of this Application the following: 
 
a) List of Officers (Full Name, Position, ID Number, Year and Course) 
b) List  of  Persons  in  Charge  of  the  Application  and  Recruitment  Process  (Full 
Name, Position, ID Number, Year and Course) 
c) List of recruits, neophytes or applicants (Full Name, Position, ID Number, 
Year and Course) 
d) Membership Definition 
e) Defined Application Process 
 
3. We  affirm  that  we  have  read  and  understood  the  provisions  of  the  Anti-Hazing  Act 
of  2018,  or  Republic  Act  No.  11053,  and  we  undertake  to  comply  with its provisions 
and  ensure  that  no  harm  of  any  kind  shall  be  committed  by  anybody  during  the 
organization’s membership application and recruitment process.  
 
4. We  affirm  that  a  copy  of  this  Application  has  been  posted  in  the  official  school 
bulletin  board,  the  organization’s  bulletin  board,  and  two  other  conspicuous  places 
in  the  school  premises,  which  we  undertake  not  to  take  down  until  three  (3)  days 
after our membership application and recruitment process is completed. 
 

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 5. We  affirm  and certify that all the information in this Application, including Annex “A”, 
are  complete,  true,  and  correct  to  the  best  of  our  knowledge  and  belief,  and  any 
misrepresentation,  falsification,  or  omission  of  any  facts  may  be  cause  for 
disciplinary action/s against the organization and/or the individuals concerned. 
 
 
 
Signed this ___ day of ____, 20___, in __________ City, Philippines. 
 
 
 
 
Karl Cedric C. Quevedo 
Musmos Ateneo 
 
 
 
Ms. Anitta Joy A. Nuevo 
Musmos Ateneo 
 
 
 
 
NOTE: 
 
SEC. 7 of Republic Act No. 8049 as amended by Republic Act No. 11053 or the “Anti-Hazing 
Act of 2018” states: 
 
“The faculty adviser or advisers shall be responsible for monitoring the activities of the fraternity, 
sorority, or organization. Each faculty adviser must be a duly recognized active member, in good 
standing, of the faculty at the school in which the fraternity, sorority, or organization is 
established or registered.  
 
In case of violation of any of the provisions of this Act, it is presumed that the faculty adviser has 
knowledge and consented to the commission of any of the unlawful acts stated therein.” 
   

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 ACKNOWLEDGEMENT 
 
REPUBLIC OF THE PHILIPPINES) 
CITY OF _____________________) S.S. 
 
I  certify  that,  on  this  date  before  me,  a  Notary  Public  duly  authorized  in  the  city 
named above to take acknowledgments, personally appeared: 
 
Name Competent Evidence of Identity Date/Place Issued 
 
Student Head   05-17-2016/LTO,East Ave. 
 
 
 
 
 
 
 
 
 
Moderator  
 
 
 
 
 
 
 
 
 
who  were  identified  by  me through competent evidence of identity to be the same persons 
described  in  this  document,  who  acknowledged  before  me  that their respective signatures 
on  the  instrument  were  voluntarily  affixed  by  them  for  the  purposes  stated  therein,  and 
who  declared  to  me  that  they  have executed the instrument as their free and voluntary act 
and deed, and that they have the authority to sign on behalf of their organization. 
 

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This  instrument  consists  of  _______  (_)  pages,  including  its  Annex  “A”  and  the  page  where 
this  acknowledgment  is written. Each and every page of this instrument has been signed by 
the parties. 
 
WITNESS my hand and seal this _____ day of __________________ 20__ at ___________. 
 
 
[NOTARY PUBLIC] 
 
Doc. No. __________; 
Page No. __________; 
Book No. __________; 
Series of 20__.