Constituent registration |

Registration

Constituent registration

Last name *

First name *

Middle name *

Suffix name

Alias

Age *

Birth date *

Gender *

Street *

House number *

Unit floor

Building name

Your email address

Your phone number *

Place of birth *

Religion *

Civil status *

What is your role in family *

Number of dependents *

Citizenship *

Educational background *

Occupation

Source of income

Covid-19 history

Registration status

Yellow card holder no.

Yellow card issue date

Yellow card expiry date

Residency status *

Others please specify

Place of residence 5 years ago

Valid id type * Select the type of government-issued ID you will upload

Valid id (Front) * Upload front side of any government-issued ID

Valid id (Back) * Upload back side of your ID if applicable

Your photo * You can take a photo or upload from gallery

I agree to allow the barangay to collect, process, and store my personal information for the purpose of constituent registration and service delivery in accordance with the data privacy act of 2012. *

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Constituent registration

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Dependents information