CONFEDERATION OF ILOCANO ASSOCIATION INC.

SAMAHANG ILOKANO
SEC. REG. No. 61892

APPLICATION FOR MEMBERSHIP

TAIWAN COUNCIL

I,___________________________________ an applicant of the CONFEDERATION OF ILOCANO ASSOCIATION INC.

known as SAMAHANG ILOKANO after having been oriented of the aims of the association embodied in Article ll of its
Constitution and By-laws. I voluntary submitted myself for initiation.

If ever I pass the screening and qualified to be a member, I promise to devote my time to promote the
welfare and lawful programs of the confederation to attain its objectives

In testimony whereof, I hereby voluntary affix my signature on __________________, 20___ at

______________________________________.

__________________________
Signature of Applicant
SCREENING COMMITTEES:

_________________________ __________________________
Recruiting Master Secretary

_________________________ __________________________
Chapter Vice President Chapter President

PERSONAL INFORMATION:
Date of Birth : __________________________________________________________________
Place of Birth : __________________________________________________________________
Address : __________________________________________________________________
School/Local Chapter : __________________________________________________________________
(If Alumni) Mother Chapter Year Accepted : _____________________________________________________
Degree : __________________________________________________________________
Association Affiliated : __________________________________________________________________
Company : __________________________________________________________________
Contact Person & No. : __________________________________________________________________
Email Address : __________________________________________________________________

Approved by:

__________________________
Atty. Julius A. Magno CPA
Founder)International Chariman