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Pambansang Tinig at Lakas Sa Pantalan: Chapter

This document appears to be a membership profile and application for PAMBANSANG TINIG AT LAKAS SA PANTALAN (National Voice and Strength at the Port). It requests basic personal information such as name, civil status, contact details, employment history, and authorizes deduction of membership fees from payroll. Upon completion, the application requires confirmation from the Chapter President and National Membership Committee Chair before the National Executive President notes the new membership.

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Bong Pasaway
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122 views1 page

Pambansang Tinig at Lakas Sa Pantalan: Chapter

This document appears to be a membership profile and application for PAMBANSANG TINIG AT LAKAS SA PANTALAN (National Voice and Strength at the Port). It requests basic personal information such as name, civil status, contact details, employment history, and authorizes deduction of membership fees from payroll. Upon completion, the application requires confirmation from the Chapter President and National Membership Committee Chair before the National Executive President notes the new membership.

Uploaded by

Bong Pasaway
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PAMBANSANG TINIG AT LAKAS SA PANTALAN

Chapter: ___________________
2” X 2” ID
PICTURE

MEMBERSHIP PROFILE/APPLICATION LATEST


PHOTO

NAME: ___ SEX:


(Surname) (First) (Middle)
CIVIL STATUS: _______ HEIGHT : (m) __ WEIGHT:(kg) __
DATE OF BIRTH: PLACE OF BIRTH:
NAME OF SPOUSE: NO. OF CHILDREN:
ADDRESS:
TIN : ___________ E-MAIL ADDRESS: _________________________
TEL.NO. (Residence) (Office) _______ (Cell phone)
PLANTILLA POSITION : _____ ___STATUS OF APPOINTMENT:
PPA EMPLOYEE ID NO.: __________ACTUAL DESIGNATION (if any)
OFFICIAL STATION (Per Plantilla Item):
ACTUAL PLACE OF ASSIGNMENT:
FIRST DAY OF SERVICE IN (a) GOV’T: (b) PPA:
YEAR JOINED PANTALAN:___________________________________________________

CERTIFIED CORRECT: (By the Applicant)

Signature over Printed Name Date

Confirmed by:

Chapter President Chairman-Nat’l Membership Committee

Date Signed Date Signed

Noted:

EMILIANO M. ESPARAGUERA,JR.
NATIONAL EXECUTIVE PRESIDENT
Date Signed:_____________

AUTHORITY TO DEDUCT
For: The HR / Administrative Manager
HO / PMO

This is to authorize deduction of the following :


1. Membership Fee (P100.00) (For new members)
2. Monthly Dues
3. Mortuary Assistance (in case of death of a member)
4. Agency fees and
5. Other Union fees.

Please remit the said amount to the local PANTALAN Chapter.

__________________ _______________________
Date Signature over Printed Name

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