PHILIPPINE ASSOCIATION OF RESEARCH MANAGERS, INC.

c/o Philippine Council for Agriculture, Aquatic & Natural Resources,

Research & Development (PCAARRD) Headquarters
Los Baños, 4030 Laguna, Philippines
Email: [email protected]
URL: http://www.philarm.webs.com

PHILARM Form No. 1

APPLICATION FOR INDIVIDUAL MEMBERSHIP 2” x 2” photo

Name: AGGABAO, MAYBELLE COLANGAN Nickname: BING

(PRINT) Last First Middle Birthdate:
Agency/Institution: KALINGA STATE UNIVERSITY Sex: ☐ Male ☐ Female
Civil Status: SINGLE
Office Address: BULANAO, TABUK CITY, KALINGA 3800
Position/Designation: INSTRUCTOR I
Phone: 0956-864-0965 Fax: NONE E-mail: [email protected]
Residence Address: PUROK 4 CALANAN, TABUK CITY, KALINGA 3800
Phone: 0956-864-0965 Fax: NONE E-mail: [email protected]
Mobile:
Brief Job Description:

Educational Attainment
Degree Year Graduated Major Field of Specialization Institution/Address
Bachelor BSED 2018 MUSIC, ARTS, PHYSICAL UNIVERSITY OF
EDUCATION AND HEALTH SAINT LOUIS
TUGUEGARAO,
UGAC SUR,
TUGUEGARAO
CITY, CAGAYAN
3500
Masters M.A P.E 2022 PHYSICAL EDUCATION CAGAYAN STATE
UNIVERSITY –
CARIG CAMPUS,
CARIG SUR,
TUGUEGARAO
CITY, CAGAYAN
3500
Doctoral NONE
Membership in Professional Organizations
Organization Position Held Dates

Significant Involvement(s) in Research or RDE/Technology Management (may refer and include in the resume/CV to be submitted)

Trainings/Seminar Attended Related to RDE and Technology Management (may refer and include in the resume/CV to be submitted)
Title Inclusive Dates Implementing Unit

References
Name Address Phone/Fax/E-mail
1.
2.
Signature of Applicant: (sign or insert specimen signature here) Endorsed by (PHILARM Member):

______________________________________________
Signature Over Printed Name
This portion to be filled up by the PHILARM Regional Chapter Membership Committee
Updated: 2021
 Date Received: Action Taken: Approve Disapprove
Date Reviewed/Evaluated: Signature of Regional MemCom Chair:
This portion to be filled up by the PHILARM National Secretariat
Date Confirmed by PHILARM BOD: PHILARM OR No./Date:
Date of Payment of Mem Fee & Ann Due: PHILARM Membership ID No.:
Note: This form together with e-copies of 2”X 2” recent photo, specimen signature (preferably in jpeg or bitmap format and in white or clear background) and curriculum
vitae/resume (in PDF or MSWord format) must be submitted to the PHILARM Regional Chapter through the Regional Membership Committee. E-copies of 2”X
2” photo and specimen signature will be used for the issuance of PHILARM ID prior to the approval & confirmation of the membership application. Accepted
applicants will be notified through a letter of acceptance via email.

Outstanding Research Manager Award Personal Data Sheet and Nomination Form 2