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ASSOCIATION OF SWIMMING OFFICIALS of the
PHILIPPINES, Inc. (ASOP) |
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Patio Isabel Resort, Sacred Heart
Village I |
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Novaliches, Quezon City |
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Tel. No. 937-22-72 |
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2 X 2 |
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SEC. Company Reg. No.
CN200303513 |
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I.D. PICTURE |
| WWW.GEOCITIES.COM/PHIL_ASOP |
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| MEMBERSHIP: |
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| PERSONAL
DATA SHEET |
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| MEMBERSHIP
FEE: Php 300.00 |
YEARLY
RENEWAL FEE: Php 100.00 |
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| 1. SURNAME |
FIRST NAME |
MIDDLE NAME |
2. SEX |
3. CIVIL STATUS |
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( ) MALE |
( ) SINGLE |
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) WIDOW |
| ( ) FEMALE |
(
) MARRIED |
( ) SEPARATED |
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IF MARRIED, WRITE MAIDEN NAME |
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5. NAME OF SPOUSE |
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OCCUPATION |
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| 6.
TAXPAYER'S IDENTIFICATION NUMBER |
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7. CITIZENSHIP |
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| 8. DATE OF
BIRTH |
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9.PLACE OF BIRTH |
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| 10. HEIGHT |
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11. WEIGHT (Kilos) |
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12. BLOOD TYPE |
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| 13. ADDRESS |
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| E-Mail Add.: |
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14.TEL./CEL NO. |
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| 15. NAME OF
OFFICE |
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16.
ADDRESS |
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17.
TEL. NO. |
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| 18.CHILDREN |
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| NAME |
AGE |
NAME |
AGE |
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| (Continue on separate sheet, If necessary) |
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INCLUSIVE |
HONORS |
| 19. EDUCATION |
NAME OF SCHOOL/ |
DEGREE EARNED |
DATES |
RECEIVED |
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COLLEGE/ UNIVERSITY |
(write NONE if not |
ATTENDANCE |
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| ELEMENTARY |
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| SECONDARY |
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| VOCATIONAL |
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| COLLEGE |
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| POST GRADUATE |
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| (Continue on separate sheet, If necessary) |
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| 20. RECORD OF IN-SERVICE TRAININGS, STUDY AND
SCHOLARSHIP GRANTS AS SWIMMER, COACH, AND OFFICIATING OFFICIALS |
| Title of seminars/conference/course/training |
Designation |
Inclusive Dates |
No. of Hours |
Conducted by |
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| (Continue at the back or on separate sheet,if necessary) |
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