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Membership remittance form (rev)
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Membership remittance form (rev)

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  • 1. PHILIPPINE ASSOCIATION OF ACADEMIC/RESEARCH LIBRARIANS Rm. 301, THE NATIONAL LIBRARY BUILDING, T.M. KALAW ST., ERMITA 1000 MANILA, PHILIPPINES http://sites.google.com/site/paarlonlineorg MEMBERSHIP REMITTANCE F O R M Date: _______________________________ TO: PHILIPPINE ASSOCIATION OF ACADEMIC/RESEARCH LIBRARIES Attn: Chair, Membership Committee PLEASE REGISTER/RENEW OUR MEMBERSHIP AS INDICATED BELOW: 0* Institutional member, with our designated representative librarian, Mr./Ms. ______________________________ __________________________________________________ (state name and position of designated representative) Our mailing address is: (Please indicate below any changes in your institutional mailing address): __________________________________________________________________________________________ __________________________________________________________________________________________ 1* Individual member. (Regular , Associate) Name ________________________________________________________________________________________________ SURNAME GIVEN MIDDLE NAME Designation ____________________________________________ License No._________________ Home Address: _______________________________________________________________________________________ Institution: ___________________________________________________________________________________________ Office Address: _______________________________________________________________________________________ Email: ________________________________________________________ Cell Phone No.:_________________________ Tel No.:___________________________________________ Fax _______________________________________________ 2* Enclosed is payment for membership fee amounting to P_________, PMO/check no. _______________ dated____________ bank_________ Note: Institutional membership Fee ----- P 500 renewable annually Regular or Associate member ----- 200 renewable annually 3* We have deposited to your Banco de Oro Account No. 000-560-295-499 (UN Avenue, Manila Branch) the amount of P__________ as payment for our Institutional Membership for Year __________. 4* We will send payment personally. 5* We are interested in joining PAARLNET as institutional member. Please send us more information. For more details on Membership Information, please view PAARL website: http://sites.google.com/site/paarlonlineorg

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