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PYDN Membership Form Guide

The document is a membership form for the Positive Youth Development Network Inc.'s Membership and Accreditation System. It collects information about the applying organization called MAMBA Club, including its address, region of operation, advocacy areas, and contact details. The form signifies the organization's intention to register as a member and agrees to certain terms like consenting to sharing of information. Required documents like the organization's constitution and a list of officers must be submitted along with the completed form.

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Daniel Balubal
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93 views1 page

PYDN Membership Form Guide

The document is a membership form for the Positive Youth Development Network Inc.'s Membership and Accreditation System. It collects information about the applying organization called MAMBA Club, including its address, region of operation, advocacy areas, and contact details. The form signifies the organization's intention to register as a member and agrees to certain terms like consenting to sharing of information. Required documents like the organization's constitution and a list of officers must be submitted along with the completed form.

Uploaded by

Daniel Balubal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Membership Form. The accomplishment of this membership form signifies your application to Positive Youth Development Network Inc.

’s
Membership and Accreditation System.

I. ORGANIZATIONAL PROFILE

Name of Organization: MAMBA (Mental health Advocates Making Beyond Adversaries) Club
Address: Galapia Street, Balintocatoc, Santiago City

Region: II Country, if outside the Philippines:

Email Address: [email protected]


Website/Facebook: https://www.facebook.com/profile.php?
id=100086020772527
Contact Number: 09363840830
Community-Based / School/University-Based
Organization Type:
(Please check all that apply)
Government-Affiliated (SKs) Others, please specify:
People Planet Prosperity
Advocacy: / (no poverty, gender equality, (climate action, (sustainable cities and
(Please check all that apply) good health and well-being, affordable clean communities, reduced
etc.) energy, etc.) inequalities, etc.)
Community Level (Barangay,
/ National
Scope of Operations: Municipal, Provincial)
Subnational/Regional International

Official Contact Person: Daniel S. Balubal


Primary Email: [email protected] Contact Number: 09363840830
Secondary Email: [email protected]

References: Please input at least three (3) references.

Name Position/Affiliate Contact Details

SATURNINO R. BATARA Principal II/ Balintocatoc Integrated School


09277435879
LEILANI L. MAGALLANO Master Teacher II/Balintocatoc Integrated School 09064381407

II. UNDERTAKING.
We hereby signify our intention to register as a member of Positive Youth Development Network, Inc. and swear that:
(1) The information we provided is true and correct;
(2) The people who provided their personal information consented for the organization to do so;
(3) We consent to Positive Youth Development Network to process our registration and use the information we
provided for whatever purpose it may serve them including posting online or printing as part of the official list of
registered members of the organization; and
(4) PYDN reserves the right to suspend or revoke membership once an organization is proven to have violated the
law of the land.

We authorize the Positive Youth Development Network or its representatives to use, share, and process personal information
that we have provided, shared, or declared in this form for any lawful purposes.

Daniel S. Balubal
________________________________
Signature over Printed Full Name
of Organization Head

III. DOCUMENT ATTACHMENTS. Please submit the following documents to complete your membership:
1. Constitution and By-Laws with the Vision, Mission, and Goals of the organization.
2. List of Organizational Officers, their roles, and contact details.
Please send the complete filled-out membership form and attach the necessary documents to [email protected] with the
subject Membership-Application_OrganizationName on or before December 4, 2022.

To know more about Positive Youth Development Network, Inc.’s Membership and Accreditation System, visit our Facebook page at
www.facebook.com/PYDNOfficial

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