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Membership remittance form (rev 2017)

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Membership remittance form (rev 2017)

  1. 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 OFACADEMIC/RESEARCH LIBRARIES Attn: Chair, Membership Committee PLEASE REGISTER/RENEW OUR MEMBERSHIPAS 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): __________________________________________________________________________________________ __________________________________________________________________________________________ 0. Individual member. (Regular , Associate) Name ________________________________________________________________________________________________ SURNAME GIVEN MIDDLE NAME Designation ____________________________________________ License No._________________ Home Address: _______________________________________________________________________________________ Institution: ___________________________________________________________________________________________ Office Address: _______________________________________________________________________________________ Email: ________________________________________________________ Cell Phone No.:_________________________ Tel No.:___________________________________________ Fax _______________________________________________ 0. Enclosed is payment for membership fee amounting to P_________, PMO/check no. _______________ dated____________ bank_________ Note: Institutional membership Fee ----- P 1000 renewable annually Regular or Associate member ----- 300 renewable annually 0. 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 __________. We will send payment personally. 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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