ISABELA JOURNALISM ADVOCATES

(Isabela School Paper Advisers Association)

Membership Application Form

NAME MARY ANN A. MENDOZA
ADDRESS PUROK 04, NAGBACALAN, RAMON, ISABELA PASTE YOUR
BIRTHDAY MARCH 30, 1964 PICTURE
HERE
EMAIL ADD. maryann.mendoza002@deped.gov.ph
CONTACT # 09175058664

School: ________________________________________________
NAGBACALAN ELEMENTARY SCHOOL
________________________________________________

School Address:
________________________________________________
NAGBACALAN RAMON ISABELA
________________________________________________

Schools District: ________________________________________________

RAMON DISTRICT
Legislative District: ________________________________________________
LD 3

School Paper: ________________________________________________

NEWS BLAST
Years in Service as SPA: ________________________________________________
5 YEARS

This is to certify that I voluntarily signify my intention to be a member of the Isabela

Journalism Advocates (Isabela School Paper Advisers Association). I do hereby pledge
that I will do my best at all times to support the activities of the association and will abide
by its Constitution and By-laws. I also acknowledge my duties and obligations needed of
me as a member and will keep myself aware of all its endeavor

MARY ANN A. MENDOZA

_________________________________
(Signature Over Printed Name of Member)

Approved by: LABI L. UPAM, JR.
President

This is to acknowledge the receipt of Sixty PESOS ONLY (PhP 60.00) from _______________
_______________________________________________
MARYANN A.MENDOZA in payment for his/her membership
fee for the Isabela Journalism Advocates (Isabela School Paper Advisers Association).

Received by:__________________________
Date: March 25, 2023