TAU GAMMA PHI/TAU GAMMA SIGMA
Triskelions’ Grand Fraternity
Central/ west/ south/ sta. maria/ kiblawan community-based chapters
PADADA MUNICIPAL COUNCIL
APPLICATION FORM
PERSONAL:
Name :________________________ Nick Name:_________________ Civil Status:____________________________________
City Address : __________________________________________________ Tel. No.:_______________________________________
Prov’l Address: ___________________________________________________ Tel No.: _______________________________________
Date Of Birth : ___________ Place of Birth: ______________________________ Age: ____ Mobile No.:_______________________
EDUCATIONAL:
Year Graduated
Elementary : ____________________________________________________________________ _____________________________
Secondary : _____________________________________________________________________ _____________________________
College : _____________________________________________________________________ ____________________________
Others : _____________________________________________________________________ _____________________________
FAMILY BACKGROUND:
Name Occupation Company / Agency
Father : ______________________________ __________________________ ________________________________________
Mother : ______________________________ __________________________ ________________________________________
Number of Brother/s: _________ Number of Sister/s: _________
Close relatives connected with Government agency and private agency / corporation:
Name Company / Agency Position Relationship
__________________________ _________________________ ______________________ _____________________________
__________________________ _________________________ ______________________ _____________________________
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ORGANIZATIONAL AFFILIATION:
What are your present activities? __________________
Are you a member of any organization? ____ If yes (youth / rotary /glee club, cause oriented, NGO’s fraternity etc…
Name Position Year Nature or Type
___________________________ _______________________________ _______________ ______________________________
___________________________ _______________________________ _______________ ______________________________
Close Relatives connected to the Government, Private Company, Tau Gamma Phi/Tau Gamma Sigma
Name Position Year Nature or Type
___________________________ _______________________________ _______________ ______________________________
___________________________ _______________________________ _______________ ______________________________
What is your main concept of the fraternity system? __________________________________________________________________
Why do you want to join the fraternity? ____________________________________________________________________________
Who encourage you to join the fraternity? _________________________ When? __________When did he / she convince you to join
fraternity? _______________ Do your parents know that you are joining a fraternity? ________________________________________
Have you ever joined or quitted or been differed in other fraternity? ____ If yes, what fraternity? _______________________________
What can you contribute for the betterment / improvement of the fraternity?
_____________________________________________________________________________________________________________
Do you have any physical ailment? _____ if yes, pls notify ____________________________________________________________
Do you have any relative / friend who is member of this fraternity? _____ if yes, indicate who, what chapter position & your relationship.
Name Chapter Position Relationship
__________________________ ____________________ __________________________ _________________________________
__________________________ ____________________ __________________________ _________________________________
__________________________ ____________________ __________________________ ________________________________
Have you ever been convicted, arrested or penalized by any authority? ____ If yes, what is the offense committed & status: ________
___________________________________________________________________________________________________________
I hereby, certified that all of the above answer is true and correct to : ( Don’t fill-up this space)
The best of my knowledge and capacity. Any wrong information : Name of interviewer: __________________________________
Found shall mean cancellation of my application. : Position: _____________________________________________
Signed: __________________________________________ : Recommendations, suggestions and comments: ______________
Date: ____________________________________________ : ____________________________________________________
