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PHILIPPINE COAST GUARD AUXILIARY
109th COAST GUARD AUXILIARY SQUADRON
419 W. BURKE ST. BINONDO, MANILA
TEL. / FAX NO. 242-02-66

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APPLICATION / BIO - DATA

NAME:

NICKNAME:

CITY ADDRESS: TEL.NO.:
BIRTHDAY: BIRTH PLACE:
CITIZENSHIP: RELIGION: CIVIL STATUS:
COLOR OF EYES: COLOR OF HAIR: HEIGHT:
WEIGHT: BLOOD TYPE: SEX:
DISTINGUISHING MARK:
NAME OF SPOUSE: NO. OF DEPENDENT:
NAME OF DEPENDENT: AGE:
   
   
   
   

EDUCATIONAL ATTAINMENT:

LEVEL SCHOOL YEAR ATTENDED DEGREE EARNED

ELEMENTARY:

     
SECONDARY:      
COLLEGIATE:      
VOCATIONAL:      
POST-GRAD.:      
GOVERNMENT EXAMINATION PASSED:
TITLE YEAR TAKEN RATING
     
     
     
ROTC TRAINING:
BASIC GRADUATED: ADV. GRADUATED:
RANK HELD: POSITION HELD:
AWARDS RECEIVED:
 
MILITARY BACKGROUND:
Branch of Service: Position:
Rank: Serial No.:
Unit Assigned:
WORK EXPERIENCE:
Position in the Company:
Year of Service:
Name of Company:
Address:
Tel. Number: Fax Number:
Nature of Business:
ORGANIZATION:
NAME OF ORGANIZATION POSITION YEAR
     
     
     
IN CASE OF EMERGENCY, NOTIFY:
NAME: TEL. NO.:
ADDRESS:
          I hereby certify that the above information is true and correct to the best of my knowledge and ability. Any misinformation or inaccurate data given above is a ground for disapproval of this application.
  Signed:
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