JUNIOR PHILIPPINE INSTITUTE OF ACCOUNTANTS

Ateneo de Davao University Local Chapter

E. Jacinto St., Davao City
SY 2016-2017

Participant Information Sheet

To be accomplished by the participant

Name
Surname

First Name

Middle Initial

: of

Date
Birth

Ag :
e

(
MM/DD/YY)

Year
Section

Nicknam
:
e

E-mail
Address

: &

Mobile :
#

:
r

_____

Facebook URL:
_
What is your latestst Semester,
QPI?
(1
2016
Talent
Skills

-2 SY
17
0)

__

and
:
Signature over printed name and date

I,__________________________, certify that I am not a top 5 title holder of last year's

Search for Mr. And Ms. Ambassador of Goodwill. I also certify that I have not
undergone any disciplinary sanction before entering this competition, and that
I have no failing grades in any subject. Furthermore, I understand that if I am
chosen as the Mr. or Ms. Ambassador of Goodwill 2016, I shall represent the
JPIA Ateneo de Davao University Local Chapter on the upcoming regional
pageant to be held on the NFJPIA-RXIC Annual Regional Convention.

A member of the Ateneo de Davao University Campus Clubs Organization