Application for Regular Membership

Personal Information

MaleFemale

MarriedSingleSingle but Head of FamilyWidowedSeparatedSolo Parent
ElementaryHigh SchoolVocationalCollegePost Graduate
GovernmentPrivate/OFWSelf-Employed

Family Profile

Household Member ( 1 )

YesNo

Household Member ( 2 )

YesNo

Household Member ( 3 )

YesNo

Household Member ( 4 )

YesNo

Household Member ( 5 )

YesNo

Real/Personal Property

PermanentSemi-PermanentTemporary

RiceCornSugarcaneCoconut

CarMotorcycleTricycleOthers

BENEFICIARIES

Beneficiary ( 1 )

Beneficiary ( 2 )

Beneficiary ( 3 )

Occupational & Special Interest Skills

Rice FarmingCorn FarmingSugarcane FarmingAbaca ProductionOrchard FarmingLivestock RaisingPoultry RaisingCarpentryMasonryWeldingPlumbingElectricalCabinet MakingFurnitureUpholsterySewingDressmakingTailoringEmbroideryCookingFood ProcessingBeauticianManicure/PedicureHair StylingBarberMassagerWatch RepairElectronic RepairHome Appliance RepairHandicraft MakingBag MakingMechanincIron WorksRecycling

Membership in Other Cooperatives

Member’s Subscription Agreement

In connection with my membership to this Cooperative, I hereby subscribe 100 Common/Preferred Shares valued at One Hundred Pesos (P100.00) per share or equivalent to Ten Thousand (Php 10,000) Pesos on the following terms and conditions.

  1. I agree to pay the initial amount of at least Five Hundred (P500.00) Pesos upon subscribing and the balance payable in monthly installment until the whole subscription is fully paid. I agree that the unpaid balance of my subscribed capital is my liability to this Cooperative.
  2. I agree that I could guarantee/sell a portion of my share capital to any member with prior approval by the Cooperative. I agree that I could make claims to my share capital contribution upon termination of membership without pending obligation and subject to the Cooperative applicable policies, systems and procedure.

Undertaking

I hereby agree and certify that the above information is true and correct

Attachment

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