TONDONIAN’S CAMPUS INTEGRITY MOVERS (THS-CIM)

(Name of Organization)
TONDO HIGH SCHOOL
(Name of School/College/University)
DIVISION OF CITY SCHOOLS - MANILA
(DepEd Division/Place of College/University)

THS- CIC MEMBERSHIP/APPLICATION FORM

SY 2023- 2024

What is CIC?
The Tondonian’s Campus Integrity Movers (THS-CIM) of Tondo High School also known as
CAMPUS INTEGRITY CRUSADERS (CIC) is a non-partisan school-based youth organization recognized by
the Department of Education, Division of City Schools – Manila and duly accredited by the Office of the
Ombudsman; aims to empower the youth in their involvement in corruption prevention initiatives by developing
their leadership skills and instilling values of integrity, honesty, and social responsibility.

Be one of Us! : Please fill-in the APPLICATION FORM with complete and rightful informations. Include to or answer
some inter-personal questions leading your way to become a possible and official officers/members of the CIC
Organization.
Surname: LRN No:
First Name: Grade/Sec:
Middle Name: Personal Contact No:
Nick Name: Fb Account:
Address: Email:
Barangay No/ Zone/ /District:
Birthday: Birth Place:
Name of Parent/Guardian:
Occupation: Contact No. Incase of Emergency:
Are you willing to empower the youth in their involvement in corruption prevention through your leadership/
initiatives? YES ______ NO ______ Are you willing to give time/effort to the organization? YES_____ NO _____
What values do you want to instill to the youth as you participated to become an active member/officers of the
CIC? Honest _______ Integrity ________ Responsible ________ Others (pls specify) _______________
Advocacy(s) willing to support, promote, and engage with. (Check as many as you (for membership ID
want) purposes)
c Disaster Risk Reduction and Management
c Mental Health and Psychosocial Support for Children and the Youth
c Education and Livelihood for the Poor
c Health and Body Wellness
c Environmental Protection and Climate Action Insert Photo
c Gender and Development (GAD)/Equality and Diversity
c Promotion of History, Tourism, Cultural Heritage and Arts.
c Escaping Domestic Violence/Anti- Bullying Campaign
c Animal Right/Protection
c Caters to the Elderly/Senior Citizens
c Religious Worship and Character Building
c Others. Pls Specify: ___________________________________________
Sign/E-Signature

I, ______________________________ of (Grade/Sec) ___________ declare under oath, that the entries made by
me in the Application Form as ______________ (member/officer) of the Campus Integrity Crusaders (CIC) are complete
and true to the best of my knowledge, belief, and information. I understand that I am obliged to do my roles, duties, and
responsibilities including to participate, promote, and support the enroll activities of the organization for this school year
(SY) __________.

I hereby sign this AGREEMENT freely and with full understanding of my functions, privileges, and obligations
in this __________ day of ________________ in the year of our Lord ________.

SUBMITTED BY:

__________________________________
SIGNATURE OVER PRINTED NAME
ENDORSE/APPROVED BY:

_________________________________________
ASSIGN OFFICER/ADVISER, THS-CIC CLUB