THE FRATERNAL ORDER OF

Eagles
(Philippine Eagles)
First Philippine-Born Fraternal Socio-Civic Organization
Service Through Strong Brotherhood

APPLICANT PERSONAL DATA SHEET

 Fill-up completely and legibly using black ink.
 Indicate “N/A” if not applicable.
 Attach a 2”x2” ID picture with white background. Write your surname at the back of the photo.
I. PERSONAL INFORMATION
SURNAME Aranas
FIRST NAME Vergel
MIDDLE NAME Andus

NICKNAME
Boyeng RESIDENTIAL ADDRESS Sitio Bacud, Brgy. Luna,
DATE OF BIRTH (mm/dd/yyyy) 08/15/1989 Surigao City
8400
 Single  Widowed 09773342583
CIVIL STATUS  Married  Separated ZIP CODE
CONTACT NO.
 Annulled  Others, specify
PLACE OF BIRTH Cabungan-an, Cagdianao, Dinagat Province PERMANENT/PROVINCIAL
ADDRESS Sitio Bacud, Brgy. Luna,
CITIZENSHIP Filipino Surigao City
ZIP CODE
8400
HEIGHT 5’5.5” CONTACT NO.
09773342853
WEIGHT (kg) 80Klg
BLOOD TYPE A+ RELIGION IFI E-MAIL ADDRESS icevergel@gmail.com
SSS/GSIS NO.
MOBILE NUMBER(S) 09773342583
PAG-IBIG ID NO. 121117009742
PHILHEALTH NO. TIN NO.

II. FAMILY BACKGROUND

FULL NAME DATE OF BIRTH (mm/dd/yyyy) AGE
SPOUSE
(Maiden Name)

CHILDREN

III. EDUCATION
PRIMARY YEAR
Cabunga-an, Elementary School GRADUATED 2000
SECONDARY YEAR
Surigao Norte National High School GRADUATED 2009
TERTIARY/COLLEGE YEAR
Surigao State College of Technology GRADUATED 2013
COURSE
BS Information Technology
YEAR
GRADUATED
GRADUATE STUDIES YEAR
GRADUATED
YEAR
GRADUATED
SPECIAL SKILLS Web Developer – Computer Programmer HOBBIES Riding Motorycle
IV. PROFESSION/EMPLOYMENT
NAME OF OFFICE/BUSINESS ESTABLISHMENT Wealth Magnet PTY LTD
LINE OF BUSINESS Australan Investment Education
OFFICE/BUSINESS ADDRESS 36 Upton Street, Bundall QLD 4217
CONTACT NO. +61755854285 E-MAIL
POSITION/DESIGNATION Full-stack Web Developer/Programmer
 V. MEMBERSHIP IN OTHER FRATERNITIES, ORGANIZATIONS & ASSOCIATIONS
NAME OF ORGANIZATION / ASSOCIATION POSITION
(Write in full)

SCINETTEK LEAGUE Member

SUZUKI RAIDER’S CLUB – Surigao Chapter Past President/Member

VI. Q & A
I.a. Do you have any relatives that are members of any Eagles Club?  YES  NO
If YES, give details:

1.b. Do you have any history whereby your application for membership was rejected by any  YES  NO
fraternity or organization? If YES, give details:

II.a. Have you ever been formally charged?  YES  NO

If YES, give details:

II.b. Have you ever been a party to any criminal, civil or administrative case?  YES  NO
(Include pending cases) If YES, give details:

II.c. Have you ever been convicted of any crime or violation of any law, decree, ordinance or  YES  NO
regulation by any court or tribunal? If YES, give details:

_
III. Do you have any pending applications for membership in any other fraternities or  YES  NO
organizations? If YES, give details:

_
I hereby certify that I have voluntarily and freely accomplished this Personal Data Sheet and all the information contained herein is true, correct, complete and is based on my personal
knowledge.

I hereby authorize the Membership and Extension Committee of the Lipata Gateway Eagles Club or it’s authorized representative to verify and validate the contents stated herein.

SIGNATURE OF APPLICANT (Sign inside the box) DATE ACCOMPLISHED (Write in full)

NAME OF SPONSOR NAME OF CLUB

Lipata Gate Eagles Club

Eagle Emmanuel R. Salvador
ENDORSED BY:

Eagle_________________________________________ _ Eagle___________________________________
CHAIRMAN, CLUB COMMITTEE ON MEMBERSHIP/SCREENING (Name, Date & Signature) CLUB PRESIDENT (Name, Date & Signature)
CONCURRED BY: RECOMMENDING APPROVAL:

Eagle Eagle _
ROSEI Director / REGION National Executive PEIL Director

Eagle___ALLAN B. JAPOR _________________ Eagle _

Secretary General
Regional Governor / REGION

APPROVED BY:

Eagle _
National President, TFOE-PE

TFOE-PE Form 101