Attach 2” x 2” colore d
photo taken not more
than 6 months ago
贴入近6 个月内的
2*2 APPLICATION FORM FOR PRINCIPAL RETIREE(Entries must be t ypewritten)
. ()
SRRV Options(Please Check √)请勾选
SMILE Classic  Human Touch Courtesy
(if necessary, use additional sheet)
Gender性别submitting
Male
Female
Date of Birth
出生日期
Place of Birth
出生地点
Nationality 国籍
ID No. 身份证号
Nationality国籍
Civil Status
Single 未婚Married已婚□Divorced离婚□Widowed丧偶
Height Weight
Valid Until
Name of Father  父亲姓名
英文 中文 Age 年龄
Name of Mother  母亲姓名
英文 中文
Age 年龄
Name of Contact Person in  Case of Emergency
紧急联络人姓名
Contact No.电话号码
Nationality  国籍:
Relationship  关系
Address  紧急联系人地址
Employment in the last three
(3) years. 三年内服务过的单位Company Name  服务单位 and Address  地址
Job Title  职位
From/To (mm/yyyy~mm/yyyy)
期间（月/年）
1 ___________________________________________        _______________        _______________________
2 ___________________________________________        _______________        _______________________
3 ___________________________________________        _______________        _______________________
Name and Address of Present Company / Business (if any)
目前服务/退休单位名称及职称: _______________________________________________________________
Contact  No .  电话号码
(To be accomplished by PRA Personnel)                                                                                        ---------------------------------------------------------------------------------------------------------------------------------
Date of Receipt of Application :    _____________________________
Papers Reviewed & Certified Complete by:  (Please indicate complete name, designation, and long-form
signature)
Comments / Remarks:
-------------------------------------------------------------------------------------------------------------------------------------------------------
(To be accomplished upon issuance of SRRV)                                                                                    ------------------------------------------------------------------------------------------------------------------------------------------------------- SRRV Number: ______________________________
Date of Issuance: ______________________________
Date of Oath-taking: ______________________________
FOR MARKETING RESEARCH PURPOSES
1How did you learn about SRRV?
Other Websites
2 Have you visited the Philippines prior to joining The PRA Program? Yes  No
If Yes, how many times?        When was the last time you visited?
On the average how long did you stay?  Where did you stay?
3 Which part of the Philippines do you particularly plan to stay longer?
Subic Metro Manila Tagaytay
4    I would like to receive updates / news about PRA and its partners, thru the following:
Phone No.:
By Email                  Email Address:
Postal Address:

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