1. MAKATI MEDICAL CENTER COLLEGE OF NURSING
ALUMNI ASSOCIATION, INC.
A NON-PROFIT, NON-STOCK CORPORATION
4TH FLOOR LIBRAN HOUSE 144 LEGASPI CORNER V.A. RUFINO ST. LEGASPI VILLAGE MAKATI CITY 1220
MEMBERSHIP FORM
ALUMNI REGISTRATION NO.: CITIZENSHIP GENDER BIRTHDAY (MM/DD/YYYY)
⃝ MALE ⃝ FEMALE
FIRST NAME MIDDLE NAME/MAIDEN NAME
LAST NAME NICKNAME:
CIVIL STATUS EMAIL ADDRESS/ES MOBILE LANDLINE FAX
⃝ SINGLE
PERSONAL:
⃝ MARRIED
⃝WIDOW/ER
BUSINESS:
HOME ADDRESS
COMPANY POSITION
EDUCATIONAL BACKGROUND
YEAR GRADUATED DEGREE COLLEGE
COLLEGE
GRADUATE SCHOOL
If you have not/ did not finished a degree, please indicate the college, level, and years of stay (e.g. AB Psych 3rd year, 1996 – 1999)
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MEMBERSHIP CATEGORY
WE WELCOME YOU TO MAKATI MEDICAL CENTER COLLEGE OF NURSING ALUMNI ASSOCIATION!
The Association thrives because of the Alumni members’ support through their membership and donations.
As part of the Alumni Association, you will receive benefits that are continuously growing!
FEES VALIDITY
⃝ Student Alumni Associate P 100 1 year
⃝ Provisionary Member P 300 2 years
⃝ Renewal/ Old Member P 300 2 years
⃝ Replacement (For damage or lost P 100 Carried over from the previous card
valid cards only)
⃝ Pick- Up ⃝ Delivery
Delivery Fees
(deliverables are sent via registered mail)
⃝ Within the Philippines? ⃝ Outside the Philippines?
P 100 P 200
Delivery Address:
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