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Professional Boxing License
GAB application form for professional boxing license and other contact sports
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Revised 2006
BOXING AND OTHER CONTACT SPORTS
GAMES AND AMUSEMENTS BOARD
2/F Legaspi Towers 200, Paseo de Roxas
Makati City, Tel. No. (632) 810-51-77
NEW
APPLICATION FOR LICENSE
(Please check the appropriate license for which you are applying)
BOXER/FIGHTER
PROMOTER
TRAINER
RENEWAL
License No.:
WRESTLER
MANAGER
SECOND
REFEREE
PHYSICIAN
MATCHMAKER
JUDGE
ANNOUNCER
TIMEKEEPER
PERSONAL INFORMATION
NAME:
RING NAME:
ADDRESS:
STATUS:
HEIGHT:
DATE & PLACE OF BIRTH:
FATHER/MOTHER’S NAME:
ADDRESS/CONTACT Nos.:
PHONE/MOBILE No.:
WEIGHT:
EDUCATIONAL BACKGROUND: (please check)
1.
2.
3.
AGE:
HAIR COLOR
CITIZENSHIP:
ELEMENTARY
EYE COLOR
EMAIL:
HIGHSCHOOL
ARE YOU CURRENTLY UNDER ANY MANAGEMENT OR PROMOTIONAL CONTRACT
HAVE YOU BEEN CONVICTED/ACCUSED OF ANY CRIME
HAVE YOU EVER BEEN DENIED A LICENSE BY GAB
x
COLLEGE
YES
YES
YES
(For Ring Officials Only)
1. HAVE YOU ATTENDED AND SUCCESSFULLY COMPLETED GAB BOXING SEMINARS
YES
(For Boxer Applicant Only);
MANAGER’S NAME:
TRAINER’S NAME:
HOW LONG HAVE YOU BEEN BOXING PROFESSIONALLY:
AMATEUR RECORD:
HOW LONG HAVE YOU BEEN TRAINING:
FIGHT RECORD:
NO
NO
NO
NO
I certify that I have read and understand the rules and regulations pertaining to the license for which I am making application,
that all information given is my own, is true and correct to the best of my knowledge. I further understand and agree that any false or
misstatements on the application will constitute grounds for revoking or denial of the license. I further agree to abide by all rules and
regulations pertaining to the government of boxing and other contact sports in the Philippines.
Signature of Applicant:
Date:
I HAVE PHYSICALLY EXAMINED herein applicant
__________________ 20__________ and hereby certify him/her fit.
at
_________________________________
on
___________________________________
(Print NAME/SIGNATURE)
GAB Accredited Physician/PTR No._________
Clinic Address:__________________________
Phone/Mobile No.:_______________________
Bill No.: _________________
Amount: ________________
O.R. #: __________________
Cashier: _________________
Picture
1.5 X 1.5
RECOMMENDING APPROVAL:
DIOSCORO B. BAUTISTA
Chief, Boxing and Other Contact Sports
APPROVED/DISAPPROVED:
APPROVED BY:
DATE:______________, 20____
OFELINA C. RETARDO
Chief Administrative Officer
