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Pledge Form

This document is an application form for active collegiate membership in the Alpha Phi Omega Philippines fraternity. It contains information about the applicant such as name, address, birthdate, degree course and year level. It also includes a pledge by the applicant to abide by the fraternity's code and ideals. The form is certified by chapter officers to confirm the applicant completed the required pledge program. It requests membership in the fraternity and provides personal details for the membership committee and administrative office.

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Lyn dela Rosa
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65 views2 pages

Pledge Form

This document is an application form for active collegiate membership in the Alpha Phi Omega Philippines fraternity. It contains information about the applicant such as name, address, birthdate, degree course and year level. It also includes a pledge by the applicant to abide by the fraternity's code and ideals. The form is certified by chapter officers to confirm the applicant completed the required pledge program. It requests membership in the fraternity and provides personal details for the membership committee and administrative office.

Uploaded by

Lyn dela Rosa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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APO Pledge Program Form No.

As of 18 August 2006

Alpha Phi Omega


Philippines, Incorporated
301-A, Two Seventy Midtower Condominium
270 Ermin Garcia St., Cubao, Quezon City

Date: September 31, 2013

APPLICATION FOR ACTIVE COLLEGIATE MEMBERSHIP Attach recent


unretouched
To : National Executive Council 1”x 1” picture
Thru : The Committee on Membership without
The Vice President for the Fraternity / Sorority glasses
or headgear.
I humbly apply as a New Collegiate Member after having completed the APO Pledge Program in the Gamma
Epsilon of the Alpha Phi Omega Philippines, Incorporated conducted from September 12, 2009 to September 21, 2013.

ON MY HONOR, I hereby affirm that I shall abide by our National Code of By-Laws; comply with all lawful orders
of our duly constituted leadership; maintain my good standing by fulfilling the duties of membership and paying my
dues; endeavor to realize the ideals of the organization by studying hard to excel in my academic studies; develop my
leadership potentials; extend my hand of friendship to all regardless of race, religion, social class, or political
ideology; and render service to the university/college and faculty, to the community, and the Nation as fully
participating citizens as guided by the principles of the Scouting Movement. I shall, in all my dealings, uphold the
dignity of Alpha Phi Omega by good example through my thoughts, words and deeds.

All These I promise without mental reservation or purpose of evasion.

JAIME C. DILIDILI
(Signature over Printed Name)
----------------------------------------------------------------------------------------------------------------------------------
--------------------------------
INFORMATION FOR THE COMMITTEE ON MEMBERSHIP
AND THE NATIONAL ADMINISTRATIVE OFFICE
(Please accomplish in BLOCK LETTERS)

NAME OF APPLICANT: JAIME CONRADO DILIDILI


(First Name) (Middle Name) (Surname)
HOME ADDRESS: #360 LOPEZ JAENA POBLACION 2 INDANG CAVITE
(No.) (Street) (Barangay) (Municipality/City) (Province)
BIRTHDATE: MARCH 24, 1990 DEGREE COURSE: BSBA-EM YEAR LEVEL: 4TH
SCHOOL / ADDRESS; DELA SALLE UNIVERSITY , TAFT AVENUE, MANILA
INSURANCE BENEFICIARY: ____________________________________ RELATIONSHIP: _______________________________
----------------------------------------------------------------------------------------------------------------------------------
--------------------------------

CERTIFICATION OF CHAPTER OFFICERS

This is to certify that Jaime C. Dilidili has completed the APO Pledge Program as per schedule
submitted on ________________________________________________. Submitted herewith are Certified True Copies of
the following: 1) Certificate of Completion of Leadership Development Phase; Friendship Development
Phase and Service Development Phase; 5) BSP Rover Scout Training and/or; PNRC Disaster Response
Training; and 7) Pledge Membership Completion.

____________________________________ ___________________________________
(Signature over Printed Name and ID Number) (Signature over Printed Name and ID Number)
ID Officer Grand Chancellor /Grand Lady
Chancellor
Contact No: __________________________________ Contact No: __________________________________
e-mail address: _______________________________ e-mail address: ________________________________

(Softcopy of this form is available at http://www.come.apo.org.ph. This form may be photocopied as needed.)

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