Congratulations on choosing to be an active member of your alumni association.

The more Lasallians come together,

DLSAA Card
the more we can do together to live up to the challenge given to us in becoming Christian Achievers for God and Country.
Network with fellow Lasallians with similar interests, industry and advocacy. We’d love to hear from you!

De La Salle Alumni Association Since 1916

Application Form MEMBERSHIP CATEGORIES AND FEES
Each category entitles you to benefits which we continually upgrade. For updated benefits, visit us at www.dlsaa.com.

STUDENT ID NO. BIRTHDATE (MM/DD/YYYY) GENDER CITIZENSHIP LIFETIME PREMIUM LIFETIME AMOUNT VALIDITY
MEMBERSHIP AMOUNT VALIDITY MEMBERSHIP
MALE FEMALE
Archer Quiver BRONZE P10,000 LIFETIME
FIRST NAME NICK NAME MIDDLE / MAIDEN NAME LIFETIME P5,000 LIFETIME
Archer Quiver SILVER P20,000 LIFETIME

LAST NAME CIVIL STATUS

DISCOUNTED / PROMO RATES Archer Quiver GOLD P50,000 LIFETIME
for BACHELOR’S DEGREE P2,000 LIFETIME
SINGLE MARRIED OTHERS First time applicants since 2011 Archer Quiver PLATINUM P100,000 LIFETIME
HOME ADDRESS for ALUMNI age 60 and above P2,500 LIFETIME Archer Quiver DIAMOND P200,000 LIFETIME

COMPANY POSITION
NON-LIFETIME
MEMBERSHIP AMOUNT VALIDITY CARD REPLACEMENT AMOUNT VALIDITY
PERSONAL EMAIL ADDRESS BUSINESS EMAIL ADDRESS
RENEWAL P2,000 2 YEARS REPLACEMENT P100
Carried over
from previous
is for lost or damaged card only.
card
You will be asked to submit a copy of an
LANDLINE (HOME) LANDLINE (WORK) MOBILE NO. NEW GRADUATES with P0.00 2 YEARS Affidavit of Loss.
BACHELOR’S DEGREE
2 years validity will start on the year of graduation

EDUCATION
LA SALLE SCHOOL DEGREE DEGREE CODE MONTH & YEAR YEARS PICK UP DELIVERY within the Philippines (P150) outside the Philippines (P250)
GRADUATED OF STAY
BACHELOR’S DEGREE DELIVERY ADDRESS same as in HOME ADDRESS
DLSU MA / MS / MBA / Law / PhD
2-Yr Certificate/Diploma Program
DLSU GRADE SCHOOL
INTEGRATED SCHOOL HIGH SCHOOL
(from 2013) SENIOR HIGH SCHOOL IN CASE OF EMERGENCY
NAME OF CONTACT
DLSU GRADE SCHOOL
(up to 1984)
RELATIONSHIP TO APPLICANT
DE LA SALLE COLLEGE
HIGH SCHOOL ADDRESS
(up to 1968)
Those who have enrolled, but not necessarily graduated, for at least 6 terms, can avail the DLSAA Card. CONTACT NO/S. EMAIL
Please indicate years of stay (e.g. 1973-1975). You will be asked to submit a copy of your TOR.

CHAPTER The DLSAA would like to keep you updated with its events and services through e-newsletters, event marketing or
Your chapter depends on the college or campus you are from. Every chapter has a president. promotional materials,and other information that may be of interest to you. Remember that you may opt out at any time.
You may get in touch with your presidents via www.dlsaa.com For more information, please visit our website and view our Privacy Notice (www.dlsaa.com/privacy).
College of BUSINESS College of LAW Yes, I want to receive the latest DLSAA updates by email, text message, or post.
GRADE & HIGH SCHOOL MANILA
College of COMPUTER STUDIES College of LIBERAL ARTS (GS up to ‘84; HS up to ’68)
College of EDUCATION College of SCIENCE DLSU INTEGRATED SCHOOL

2019OCT
College of ENGINEERING School of ECONOMICS (GS/HS/SHS from 2013 onwards)

FOR DLSAA STAFF USE ONLY Applicant’s Signature

MEMBERSHIP CATEGORY VALIDITY REMARKS
De La Salle Alumni Association
Rm 101, Br. Andrew Gonzalez Hall, De La Salle University, 2401 Taft Avenue, Manila 1004, Philippines
MODE OF PAYMENT TOTAL AMOUNT DUE 524-4611 to 26 local 128 /DeLaSalleAlumniAssociation
www.dlsaa.com info@dlsaa.com
CASH 523-6158, 526-5612 /DeLaSalleAlumni
CARD CHECK