Republic of the Philippines

Department of Education
Region V - Bicol
SCHOOLS DIVISION OFFICE OF ALBAY

BARKADA KONTRA DROGA MEMBERSHIP FORM

FOR SY 2021-2022
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Instruction: Kindly provide the necessary 2” x 2”

information and answer the questions for your
official membership to the Barkada Kontra Droga
(BKD) Student Organization.

Name:_______________________________ Grade Level (SY 2021-2022):_______________

Contact Number:____________________ Email Address:____________________________
Home Address:__________________________________________________________________

1. Have you been a member of Barkada Kontra Droga from the previous school years?
If yes, how long and what specific activities were you involved?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

2. Why did you decide to join the organization and what is/are the significant
action/s do you plan to contribute for this advocacy?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

PARENT’S / GUARDIAN’S CONSENT

I hereby permit my son/daughter to join the BKD Student Organization for SY 2021-
2022. I also commit to support his/her organizational undertakings related to the
various projects and activities of the BKD and National Drug Education Program
(NDEP).
__________________________________
Signature over Printed Name

To be filled out by the BKD Adviser only:

Recommending approval:

_________________________
BKD Adviser Approved:

______________________
School Head

Ligñon Hill, Bogtong, Legazpi City

(052)7425380 / (052)7425381
albay@deped.gov.ph