Diocese of ______________

Parish: ______________________________________________________
City : ________________________________________

MEMBERSHIP APPLICATION

Date: ____________________
(PHOTO)
I wish to become a member of the PARISH PASTORAL COUNCIL Submit two
FOR RESPONSIBLE VOTING (PPCRV) and join in its movement for 1”x 1” pictures
responsible voting and responsible citizenship.

Name: ______________________________________________________ Nickname: __________________

Date of Birth: ___________________ Sex: _______ Civil Status: ___________ Citizenship: ______________
Residence Address: _________________________________________________ Tel. No.: _______________
Occupation: _________________________ Cellphone No.: _________________Fax. No.: _______________
Company: _________________________________________________________ Tel. No.: ______________
Parish Organization Membership: ___________________________________ Position: __________________
Previous PPCRV/NAMFREL Experience (Date & Assignment): ____________________________________
________________________________________________________________________________________
Preferred Activity Assignment:
( ) AMVATT ( ) Technical Assistance Group (TAG)
( ) Voters’ Education (VOTED) ( ) Logistics (Food & Supplies)
( ) Candidates’ Forum ( ) Finance & Solicitations
( ) Poll-watching (PW) ( ) Transportation & Communications
( ) Volunteer Recruitment ( ) Media Liaison Work
( ) Voters’ Assistance Desk (VAD) ( ) Post-Election Patrol (PEP)
( ) Special Witness of Truth (SWOT) ( ) Others: __________________________
( ) Power Prayer Group (PPG)/

PPCRV PLEDGE

I pledge to work for the promotion of responsible voting and responsible citizenship as a faith response
to the call for political renewal and social transformation. I further pledge to protect and strengthen the process
of free and clean elections without fear or favor, in a non-partisan manner, in the service of God and
country. In the event that I choose to become involved in partisan politics or decide to take on the noble task of
seeking an elective position in government, I shall consider myself automatically resigned from the PPCRV
and return my membership card. I further pledge to commit my time as a volunteer without expectation of
renumeration from or obligation on the part of PPCRV to guarantee my well-being during the performance of
my duties.

_____________________________________
Applicant’s Signature

Action Taken:
Recommending Approval: Approved By: Noted By:

____________________________ ___________________________ ___________________________

PPC COSH Head/Parish Coordinator Parish Priest Congressional District Coordinator

Membership No. ______________