MEMBERSHIP FORM
* Required Information
*TYPE:
___MEMBER ___NON-MEMBER
___NEW ___UPDATE
*MEMBER NAME:______________________________________________ DATE OF BIRTH:___________________
*PARENT(S) OR GUARDIAN(S)
* NAME:__________________________________________________________________________ _____________
*ADDRESS:_____________________________________________________________________________________
*PHONE:________________________________________________
EMAIL:________________________________________________________________________________
SCHOOL:____________________________________________________ _________________________________
DO YOU PLAY ANY SPORTS? ___YES ___No
If yes, please list:
_________________________________________________________________________________________________
HOBBIES & INTERESTS: _________________________________________________________________________________________________
_________________________________________________________________________________________________
*YOUR SIGNATURE:______________________________________________________________
DATE:__________________
*YOUR PARENT/GUARDIAN�S
SIGNATURE:____________________________________________________________
DATE:__________________
By my signature, I understand and abide by all the by-laws of PASA. I also understand that my information on this form will only be used exclusively for PASA and is not shared with outside parties. Liability: I hereby expressly, voluntarily, and willingly assume all risks associated with my, my spouse�s, and family�s participation in any PASA activity/event.
*Please return this completed form to the following address:
Philippine-American Society of Austin
P.O. Box 270048
Austin, TX 78727-0048
