8/8/2019 Club Membership Forms

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philcycling@gmail.com Tel.# 551-9498 Pilot Offfice , mailing address : 5138 Filmore St. Palanan, Makat City.

APPLICATION FOR CYCLING CLUB AFFILIATION 2011

Name of Club / Association _________________________________________________________________

Mailing Address _________________________________________________________________Contact Numbers _______________________________ Mobile#_________________________

CLUB OFFICERS : Name Date of Birth

AddressPresident _____________________________________ ____________

____________________________

Vice President _____________________________________ ____________ ____________________________

Secretary _____________________________________ ____________ ____________________________

Treasurer _____________________________________ ____________ ____________________________

Auditor _____________________________________ ____________ ____________________________

PRO _____________________________________ ____________ ____________________________

Cycling Club/ Association members:

NAME SEX AGE Date of Birth ADDRESS Cycling

Event

123456789

101112131415

( Use extra sheet if necessary )

We understand that an affiliation fee for Four (4) years in the amount of 1,000.00 shall be paid infavour of the PHILCYCLING Integrated Cycling Federation of the Philippines. Upon approval of thisapplication.

We understand further that the approval of this application binds our CLUB / ASSOCIATION with thefederation and therefore we shall abide the CONSTITUTION and BY-LAWS, and the RULES andREGULATION of the PHILCYCLING (Integrated Cycling Federation of the Philippines).

Certified by: Noted by:

___________________________________________ ____________________________________________________Club / Association Secretary Club / Association President

Endorsed by: Recommending Approval:

______________________________________ ______________________________________________PHILCYCLING Provincial Chairman PHILCYCLING Regional Vice President

8/8/2019 Club Membership Forms

2/2

philcycling@gmail.com Tel.# 551-9498 Pilot Offfice , mailing address : 5138 Filmore St. Palanan, Makat City.

PHILCYCLING ( Icfp ) MC Entry no. _______________ DATE __________________________2011