THE FRATERNAL ORDER OF Eagles

(Philippine Eagles)
First Philippine Born Fraternal Socio - Civic Organization
Service Through Strong Brotherhood
NAVOTAS FINEST EAGLES CLUB
MEMBERSHIP APPLICATION
PERSONAL INFORMATION:
DONDHELL “DHELL” PERUCHO ARMIZA
NAME
FIRST NAME (NICKNAME) MIDDLE LAST NAME

PLACE OF BIRTH
BINONDO MANILA
CIVIL STATUS 2X2
JANUARY 31, 1980
DATE OF BIRTH SINGLE MARRIED PHOTO
5’8” 65 KLS.
HEIGHT WEIGHT SEPARATED X WIDOW/ER

FILIPINO CATHOLIC
CITIZENSHIP RELIGION BLOOD TYPE
A+
BLK. 29A LOT 12 PHASE 2 AREA 2 DALAG ST., BRGY. NBBS DAGAT-DAGATAN, NAVOTAS CITY, METRO MANILA, 1409
ADDRESS
STREET NO. BARANGAY MUNICIPALITY/CITY PROVINCE ZIP CODE

TELEPHONE NO. CELLPHONE NO. 0931-218-4377 EMAIL

EMPLOYMENT / PROFESSION:
NAME OF OFFICE SMALL LENDING BLK. 29A LOT 12 PHASE 2 AREA 2 DALAG ST., BRGY.
ADDRESS
LINE OF BUSINESS NBBS DAGAT-DAGATAN, NAVOTAS CITY
TITLE AND POSITION CP. NO. 0931-218-4377 FAX NO.
OWNER

LIST OF LEGAL DEPENDENTS:

NAME DATE OF BIRTH AGE
SPOUSE NAME

NAME
1.

OF
2.

C
3.
H
I
4.
L
D
5.
R
E
6.
N

EDUCATIONAL ATTAINMENT:
ELEMENTARY DAGAT-DAGATAN ELEMENTARY SCHOOL SY1991
DATE GRADUATED
HIGH SCHOOL NAVOTAS NATIONAL HIGH SCHOOL SY 1996
DATE GRADUATED
COLLEGE NAVOTAS POLYTHECNIC COLLEGE UNDERGRADUATE
DATE GRADUATED
COURSE

HOBBIES BASKETBALL

SPECIAL SKILLS MECHANICAL FOR MOTORCYCLE

SPONSOR: (Regular/Active Member of the Club)

NAME DATE SIGNATURE

Eagle DONDHELL P. ARMIZA

APPLICANT’S SIGNATURE
ENDORSED BY:

Eagle Eagle
CHAIRMAN MEMBERSHIP COMMITTEE CLUB PRESIDENT (EY:2022 )

CONCURRED BY: APPROVED BY:

Eagle Eagle NELSON ALONTO SARAPUDDIN

NATIONAL PEIL DIRECTOR NATIONAL PRESIDENT (EY: 2022)
 THE FRATERNAL ORDER OF Eagles
(Philippine Eagles)
First Philippine Born Fraternal Socio - Civic Organization
Service Through Strong Brotherhood

NAVOTAS FINEST EAGLES CLUB

APPLICATION FORM FOR I.D.
NAME: ( LAST NAME, FIRST NAME, MIDDLE NAME ) CLUB POSITION:
ARMIZA, DONDHELL PERUCHO ASPIRANT
HOME ADDRESS:
BLK. 29A LOT 12 PHASE 2 AREA 2 DALAG ST., BRGY. NBBS DAGAT-DAGATAN, NAVOTAS CITY
PERSONAL CONTACT NUMBER: HEIGHT: ( FEET ) WEIGHT ( KGS ) BLOOB TYPE: RELIGION:
0931-218-4377 5’8” 65 KLS A+ CATHOLIC

CONTACT PERSON IN CASE OF EMERGENCY: CONTACT NO.:

ADELFA P. ARMIZA 0931-250-3293
BIRTH DATE: BIRTH PLACE:
JANUARY 31, 1980 BINONDO MANILA
GSIS/SSS: PHILHEALTH: PAG-IBIG: TIN NO.
336-364784-8
CLUB AFFILIATION: REGION:
NAVOTAS FINEST EAGLES CLUB NCR XXVII

CLUB PRESIDENT EY 2022: MEMBER CONTROL NO.

Eagle

CLUB PRESIDENT SIGNATURE LATEST 2X2 PHOTO EAGLE MEMBER SIGNATURE

PHILIPPINE EAGLES SECRETARIAT:

EMAIL ADDRESS:
POSTAL ADDRESS: