PFA MEMBERSHIP APPLICATION FOR ALLIED SUPPLIERS /SERVICE PROVIDERS

MEMBERSHIP APPLICATION FORM

ALLIED SUPPLIERS / SERVICE PROVIDERS
Please FILL UP completely with all the information required and submit to the Secretariat Office together with ALL the required documents stated on page 2. All information and documents are treated with STRICT CONFIDENTIALITY
Name of Company:
Business Line / Business Type:
Country of Origin:
Year Business Started:
No. of Years in Operation:
Description of Business/Products/Services:
Address:
Initial Capitalization:
Present Capitalization:
Company Asset Size:
Contact Person:
Position:
Tel:
Fax
Email
example@example.com
Mobile No.
Company Website
About the Board of Directors and Officers: (Write down all the names)
Chairman of the Board:
President / Chief Executive Officer:
Board of Directors:
Separate with comma.
Representation with the PFA: (For purposes of continuity, Official Representative should preferably be the highest officer of the organization Official Representative:Position:
Name of Official Representative:
Position:
Birthdate

MonthDayYear
Date
Tel
Fax
Email
example@example.com
Mobile No.
Name of Alternate Representative:
Position:
Birthdate:

MonthDayYear
Date
Tel:
Fax:
Email:
example@example.com
Mobile No.
Accomplished by: (Print Name):
Tel:
Fax:
Email:
example@example.com
Mobile No.
Signature

Clear
Date Accomplished:

MonthDayYear
Date
PFA Sponsor Company / References:

Give at least two references : (1) From PFA existing Board of Director/Member and (2) one from any of the following: Company's Bank or any of your affiliations with known local industry association, clubs, or other business groupings.
Company 1:
Address of Company 1:
Contact Person of Company 1:
Telephone of Company 1:
Fax Number of Company 1:
Email Address of Company 1:
example@example.com
Mobile No. of Company 1:
Company 2:
Address of Company 2:
Contact Person of Company 2:
Telephone of Company 2:
Fax Number of Company 2:
Email Address of Company 2:
example@example.com
Mobile No. of Company 2:
Has your company been sued by another party? (Business partners, clients, franchisor, franchisees or suppliers, etc)

YesNo
If yes when
Reasons
Do you now have other pending case/s in court?

YesNoDTIDOLE
Nature of the pending cases
Status
I hereby certify that all information supplied here together with all the attached documents are certified true and correct to the best of my knowledge. I understand that any inaccurate information will be ground for the disapproval, non-acceptance and/or termination of membership.

I hereby authorize PFA to verify with the relevant agencies, individuals, persons or entities, the accuracy of the foregoing data and to use the same in any lawful manner it may deem fit.
Accomplished by:
Position
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

MEMBERSHIP APPLICATION FORM

PFA Sponsor Company / References: