Kabankalan City Association of Retired Employees Inc. (KCARE)

APPLICATION FOR MEMBERSHIP

I, ___________________________, retired employee of __________________________________, do hereby apply as a member of the Kabankalan City Association of Retired Employees, Inc. of Kabankalan City, Negros Occidental, Philippines and pledged to abide by the Constitution and by-laws of the Association.

My other personal data are:

Date of Retirement  :_____________________

Date of Birth              :_____________________

Name of Spouse      :_____________________

Address                     :_____________________

_____________________

Contact Number      :_____________________

Signed this _____day of ________________, 2009.

_________________________

Signature of Member-Applicant

Recommending Approval:

MIGUEL GAPE          CRISTINA TABANDA          LEONISA MORAÑA

Chairman                           Member                                 Member

Noted:

LEOFREDO N. NOMBRE

Chairman, KCARE