2023 Pfa Membership Application Form
2023 Pfa Membership Application Form
2023 Pfa Membership Application Form
Company Information:
About the Board of Directors and Officers: (Write down all the names)
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Representation with the PFA: (For purposes of continuity, Official Representative should preferably be the highest officer of the
organization).
Give at least two references : (1) From PFA existing Board of Director/ Member and (2) one from any of the following: Company’s Bank
or any of your affiliations with known local industry association, clubs, or other business groupings.
1. Company: _______________________________________________________________________________________
Address: _________________________________________________________________________________________
Contact Person: ___________________________________________________________________________________
Telephone: ______________Fax: _______________ Email:__________________ Mobile No.: __________________
2. Company: _______________________________________________________________________________________
Address: _________________________________________________________________________________________
Contact Person: ___________________________________________________________________________________
Telephone: ______________Fax: _______________ Email:__________________ Mobile No.: __________________
Others:
2. Is your company compliant with Republic Act No. 10173 (Data Privacy Act of 2012)? _____ YES _____ NO
Documents for Submission: (Kindly submit complete documents in a black binder (following the sequence below)
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I hereby certify that all information supplied here together with all the attached documents are certified true and correct to the best of
my knowledge. I understand that any inaccurate information will be ground for the disapproval, non-acceptance and/or termination
of membership.
I hereby authorize PFA to verify with the relevant agencies, individuals, persons or entities, the accuracy of the foregoing data and to
use in the same in any lawful manner it may deem fit.
___________________________________ _______________________________________________
Pls. Print Name Position
______________________________________ _______________________________________________
Signature Date
Endorsed by:
____________________________________________ _________________________________________
Printed Name and Signature Date