MEMBERSHIP PARTY FORM (PALAWAN)

MEMBERSHIP PARTY FORM (PALAWAN)

By completing and signing this form, you acknowledge your commitment to becoming an official member of Kapuso-PM Partylist (54 Kapuso-PM). As a member, you pledge to support and uphold the party’s advocacies, initiatives, and core values, working towards the betterment of our communities. You also agree to receive updates, participate in activities, and contribute to the collective mission of promoting accessible healthcare, livelihood opportunities, and genuine public service for all.
BASIC INFORMATION
First Name*
Middle Name*
Surname*
Date of Birth*

MonthDayYear
Date
Gender*
Upload 1 Valid ID*
CONTACT INFORMATION
Mobile Number*
Email Address
Facebook Profile / Name
ADDRESS
House Number and Street Name*
Zone / Sitio
Barangay*
City / Municipality*
District
OTHER INFORMATION
Contact person in Kapuso Partylist? (Who invited you to Kapuso Partylist)*
Take a Photo to be used on your KAPUSO ID*
Do you commit to supporting Kapuso-PM Partylist, promoting its mission, and standing by its advocacies for a better future? If so, please affix your signature below as a sign of your commitment.
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BASIC INFORMATION