APPLICATION FORM FOR COMMISSION IN THE RESERVE FORCE

ARMED FORCES OF THE PHILIPPINES

(Cir Nr 4, GHQ, AFP s-2010)

1. Name: ________________________________________________________________
(Last Name) (First Name) (Middle Name)

2. Date of Birth: _______________ Tel No._________________ Age: ________________

3. Place of Birth: __________________________________________________________

4. Citizenship (state whether natural-born or naturalized): __________________________

5. Permanent Address: _____________________________________________________

a. Tel No. ______________________________________________________________

b. Office Address /Tel No. _________________________________________________

6. Marital status: ___________________ Religion: _______________________________

Dependents: (attach additional info in a separate sheet)

Name Relationship
__________________________________ ______________________________
__________________________________ ______________________________
__________________________________ ______________________________
__________________________________ ______________________________

7. Nearest kin to be notified in case of accident or an emergency:

Name and Relationship: __________________________________________________

Address: ______________________________________________________________

8. Civilian Employment (Government/ Private):

Position/Duty Employer or Firm Period Cause of

(inclusive dates) Separation

9. Present Occupation, Position and Duty performed: __________________________

10. Present position in the government; specify whether elected/appointed (for elected
and appointed government officials only)

Position Name of Government Elected/Appointed

Office/Address
11. Previous Military Experiences: (place N/A in blanks if NOT APPLICABLE)

a. Trainee Instructions: ______________________________________________

b. Place and Inclusive Dates: _________________________________________
c. ROTC Instruction: ________________________________________________
d. Military Schools Attended: __________________________________________
e. Military Service (Chronological Records of Services) (attach on separate sheet if
necessary)

(1)
(2)

12. Educational Attainment:

Name of School/Location No. of Years Degree

13. Civil Service Examination, Board or Bar passed (State effective date and rating)

________________________________________________________________________
________________________________________________________________________

14. Present status in the Reserve Force, AFP (If applicant is not a reservist, just write NA)

a. Rank, Br of Svc and AFPSN: _______________________________________

b. Unit Assignment: ________________________________________________

c. Mobilization Center: ______________________________________________

d. Have you received a notification of your mobilization unit assignment in the

Reserve Force, AFP? ______. If yes have you acknowledged it? _____ if no, state reason
of your failure to do so: __________________________________________________

e. Source of being a reservist: (whether) honorably discharged EP of the AFP,

POTC, ROTC Basic Graduate, recognized guerilla, etc. _________________________

15. Local Dialect and Foreign Language Spoken:

Tagalog Ilocano Cebuano Others

Speak
Write
Translate
16. Parents’ Information:

Father Mother
Name
Age
Place of Birth
Address
Occupation

17. Have you been accused or convicted by any court for any crime except for minor traffic
violations?
________________________________________________________________________

18. Have you taken the Armed Forces of the Philippines Service Aptitude Test (AFPSAT)
(Indicate date / place of test):
________________________________________________________________________

19. Supporting papers required in filing the application are marked X below to be submitted
in five (5) copies.

______ a. Full sized pictures of applicant (whole body)

______ b. Birth Certificate.
______ c. If licensed professional, submit photocopy of the following:

(1) Certificate from Board Examiners of the Supreme Court, PRC

Certificate/license or civil service eligibility as the case maybe.
(2) Either ROTC Basic Course or ROTC Advance Course Certificate.

______ d. If not licensed professional submit photocopy of:

(1) College Diploma (Duly authenticated by the school registrar original copy
must be initially shown to processing officer).
(2) ROTC Basic Course/Advance Course Certificate:
(3) Summer Camp Training Certificate if required.

______ e. If not college graduate, submit copy of the following: (for RA718 applicant only –
Deserving NCO)
(1) Transcript of records as proof of highest educational attainment to include
total number of college units earned if any.
(2) Basic or advance ROTC Certificate (photocopy)

______ f. If with prior military experience submit the following:

(1) Statement of military service from the Adjutant General, AFP or Major
Service Command.
(2) Photocopy of discharge orders
(3) Copy of orders of awards, decorations and or citations received for
outstanding ability and or exceptional service rendered in combat duty if the
commission being applied is based on the RA 718.
______ g. If for commission in the Chaplain Service, submit certificate from ecclesiastical
superior permitting and recommending the commission.

______ h. Physical and Medical Examination report conducted in any AFP Medical
Hospital.

______ i. Affidavit of good moral character.

______ j. Command Clearance from J2 or Major Service Command Clearance.

20. Date application accomplished: ___________________________________________

I HEREBY CERTIFY to the correctness of the entries made in this application and in
witness thereof, I hereunto set my signature, this ________ day of ____________20__ at
______________________________, Philippines.

_________________________
(Signature of Applicant)

SUBSCRIBED AND SWORN to before me this_________ day of ____________20______

at____________________________, Philippines, affiant exhibited to me his/her
Residence Certificate Nr.____________ issued on__________ in _____________ 20___.

__________________________
(Administering Officer)
REPUBLIC OF THE PHILIPPINES)
) S.S.
)

AFFIDAVIT

I, of legal age, Filipino single/married,

residing at __________________________________ after having been duly sworn in
accordance with law, do hereby depose and state:

That I am not accused of any criminal offense involving moral turpitude before any
civil court in the Philippines, neither have I been previously convicted of any offense nor
am I facing charges involving misconduct before any military court of administrative body
including any provincial or city fiscal;

That I do not advocate nor am I a mentor of any unlawful or subversive organization

that advocates the overthrow of the government of the Philippines or any other
government;

That I clearly understand that any misrepresentation or falsehood used by me in the

furtherance of my application for commission in the Reserve Force, AFP shall be ground
for court martial charges or any administrative proceedings deemed appropriate by the
proper authority.

AFFIANT SAYETH NAUGHT:

______________________________
(AFFIANT)

SUBSCRIBED AND SWORN to before me this day of ____________ 19 _______

at _____________________________ affiant exhibited to me his/her residence Certificate
No. _______________________ issued on _________________________________
at _______________________________________.

______________________________
(Notary Public)

Doc No _______________
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Series of ________________