Have you ever been convicted of any crime or violation of any law, decree, Ordinance or regulation by any Court

or tribunal? YES ( ) NO ( )
Have you ever been convicted of any administrative offense? YES ( ) NO ( )
If your answer is yes, give details of the offense.____________________________________________________
___________________________________________________________________________________________
Do you have any pending administrative case? YES ( ) NO ( )
Criminal case? YES ( ) NONE ( ) | If you have any. Give details the offense.__________________
___________________________________________________________________________________________
Do you ever been candidate in a national, Local or Barangay election? YES ( ) NO ( )
If yes, Give data and place of election and other particulars.___________________________________________
____________________________________________________________________________________________

PERSONAL QUESTIONS:
ANO ANG GUARDIANS?_________________________________________________________________________
____________________________________________________________________________________________
HANDA KA BANG, ISAKRIPISYO ANG IYONG BUHAY PARA SA KARAPATIRAN. OO ( ) HINDI ( )
AT BAKIT?___________________________________________________________________________________
___________________________________________________________________________________________
KUNG ANO MAN ANG GAWIN NAMIN SA IYO NGAYON NANUNUMPA O SUMASANG-AYON KA BA NA WALA
KAMING PANANAGUTAN SA IYO._________________________________________________________________
___________________________________________________________________________________________
ANO ANG MAS MAHALAGA SA IYO? PAMILYA O ANG SAMAHAN NA IYONG SASANIBAN
____________________________________________________________________________________________
ANO ANG MAGAGAWA MO SA GRUPO O PAPAANO MO MAIPAPAKITA SA GRUPO NA MAHALAGA KA SA
GRUPO?_____________________________________________________________________________________
____________________________________________________________________________________________

I HEREBY CERTIFY to the correctness of entries made above and hereby pledge my voluntary service to the
GUARDIANS UNITED TIGERS BROTHERHOOD INCORPORATED.
In witness fere of. I here unto affix my signature this_____________________day of________________________
20_________________at________________________________________________________________________

SPONSORED BY: (Any Member)

_________________________________ ___________________________________
(Signature Over Printed Name) (Applicant’s Signature Over Printed
Name)

_________________________________ ___________________________________
(RANK / PSEUDONYM) (SCREEN BY)

_________________________________ ___________________________________
(SCREEN BY) (NATL.MARKER)

RECOMMENDED BY: NOTED BY:

_________________________________
____________________________________

(Chapter President / Founder) (Screening Comitte Chairman/Vice

Chairman)