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NATIONAL FEDERATION OF JUNIOR PHILIPPINE INSTITUTE OF ACCOUNTANTS

REGION III COUNCIL FEDERATION YEAR 2011-2012

OFFICE OF THE REGIONAL VICE PRESIDENT FOR ACADEMICS

FORM 101-AC001 OFFICIAL APPLICATION FORM FOR ACADEMIC EVENTS

IMPORTANT: PLEASE FILL OUT ALL THE REQUIRED FIELDS ACCURATELY.

Please fill out ONE form per Academic Event.

Application Details:

First Name (Given Name)

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- -

NFJPIA Membership ID Number

Sex: Birthdate

month day year

Address:

House No./Street Town/Brgy./Subdivision City/Municipality Province

Email Address: Mobile No.

Local Chapter / School / University:

EVENT

REQUIREMENTS CHECKLIST

*must be sigend by parent or immediate relative

*must be approved by the Dean, LC Adviser, and LC President

*must be approved by the Dean, LC Adviser, and LC President

For QUESTIONS please contact:

NEIL JOHN P. MANALANG

NFJPIA R3 VP Academics *to insert photo:

at 09359065914 1 Right-click the box and select FORMAT SHAPE/P

2 Select FILL in the Left-Side Menu.

MARY GRACE C. AGUAS 3 Select PICTURE or TEXTURE FILL.

NFJPIA R3 VP Communication 4 Select Insert from:FILE.

at 09179904820 5 Click Close.

or visit

www.facebook.com/NFJPIARegionIII

NFJPIA Region III on Facebook

2x2 photo.

see instructions below

(COLORED)

*white background

PLEASE SUBMIT THIS FORM FOLLOWING THE REQUIRED FORMAT THRU EMAIL AT

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MALE FEMALE

WAIVER

ENDORESEMENT LETTER

CERTIFICATION AS ACCOUNTANCY STUDENT

http://www.facebook.com/NFJPIARegionIIIhttp://www.facebook.com/NFJPIARegionIII

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ICTURE.

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