Republic of the Philippines

BULACAN STATE UNIVERSITY

Republic of the Philippines City of Malolos, Bulacan
BULACAN STATE UNIVERSITY 1x1
City of Malolos, Bulacan
OFFICER’S PROFILE
Last Name First Name M.I. Student No.
OFFICER’S PROFILE
School Year Name of the Organization Acronym
Last Name First Name M.I. Student No.
20___ - 20___
School Year Name of the Organization Acronym Position Contact No. E-mail Address

20___ - 20___
Course Year Section College/Institute/Campus
Position Contact No. E-mail Address

Residence
Course Year Section College/Institute/Campus

Residence
In case of emergency, please notify:
Name Relationship Contact No.
In case of emergency, please notify:
Residence
Name Relationship Contact No.

Residence
ACKNOWLEDGEMENT:

I hereby certify that all the above information is true and correct to the best of my
ACKNOWLEDGEMENT:
knowledge and ability. I hereby voluntarily and willingly bind myself with rules,
regulations and laws governing BulSU Student Organizations in keeping myself with
I hereby certify that all the above information is true and correct to the best of my
my obligations as member of good standing. I understand that any misinformation stated
knowledge and ability. I hereby voluntarily and willingly bind myself with rules,
above will be sufficient ground to disapprove this application.
regulations and laws governing BulSU Student Organizations in keeping myself with
my obligations as member of good standing. I understand that any misinformation stated
above will be sufficient ground to disapprove this application.
Signature: ________________ Date: ______________

BulSU-OP-OSO-02F3 Page 1 of 1
Signature: ________________ Date: ______________ Revision: 0

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Revision: 0

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