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PARISH PASTORAL COUNCIL FOR RESPONSIBLE VOTING

Rm. 301 Pius XII Catholic Center, 1175 U.N. Avenue, Paco, Manila
Tel no.: 524-2855 / Telefax: 521-5005 / Fax no.: 528-0149
Email: parishpcrv@yahoo.com / amb.htv@i-manila.com.ph * Website: www.ppcrv.org

Arch/Diocese : ________________________________________
Parish : ________________________________________ (PHOTO)
City : ________________________________________ Submit two
1x1 pictures
VOLUNTEERS REGISTRATION FORM
Date: ____________________

I wish to become a member of the PARISH PASTORAL COUNCIL FOR RESPONSIBLE VOTING (PPCRV) in
promoting responsible voting and responsible citizenship.

Name: ___________________________________________________ Nickname: _____________________


Date of Birth: _______________ Sex: _______ Civil Status: ___________ Citizenship: __________________
Residence Address: ____________________________________________ Tel. No.: ___________________
Occupation: _________________________ Cellphone No.: _________________Fax. No.: _______________
Company: ________________________________________________________ Tel. No.: _______________
Parish Organization Membership: _________________________________ Position: ___________________
Previous PPCRV Experience (Date & Assignment)_______________________________________________
________________________________________________________________________________________
Preferred Volunteer Assignment (Please check):

( ) Voters Education (Speakers Bureau/Training) ( ) Special Witnesses of Truth (SWOT-Roving Team)


( ) Voters List Cleansing & Verification ( ) Election Monitoring System Encoders (EMS)
( ) Accountable Material Verifiable Audit Trail Team (AMVATT) ( ) Logistics (Food & Supplies)
( ) Precinct Poll Watching / Monitoring (PPW) computer literacy required ( ) Transportation & Communications
( ) Voters Assistance Desk (VAD) ( ) Finance & Solicitation
( ) Technical Assistance Group (TAG) computer literacy required ( ) Others: _______________________________

PPCRV PLEDGE

I pledge to work for the promotion of responsible voting and responsible citizenship as a faith response to
the call for political renewal and social transformation. I also pledge to work for Clean, Honest, Accurate,
Meaningful and Peaceful (CHAMP) elections without fear or favor, in a non-partisan manner, in the service of
God and country. In the event that I choose to become involved in partisan politics or decide to take on the
noble task of seeking an elective position in government, I shall automatically resign, and be considered
resigned from the PPCRV and return my membership card.

________________________________
Applicants Signature

Action Taken:
Recommending Approval: Approved By: Noted By:

____________________________ ___________________________ ____________________________


PPC President/Parish Coordinator Parish Priest Congressional District Coordinator

Issued Membership No. ______________

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