COOP Membership Form

HLURB application form for membership

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Kalayaan Avenue cor., Mayaman St., Diliman, Quezon City

I, _____________________________________________________ hereby apply for membership in the
HLURB Multi-Purpose Cooperative as regular member. I agree to faithfully obey/abide by the rules and
regulations set forth in its Articles of Incorporation and By-Laws.
I hereby pledge to:
1. Attend and finish the prescribed membership orientation/seminar;
2. Pay the membership fee of Php 200.00 (or as may be determined by the BOD).
3. Participate in the following savings program:
a. Subscribe for at least ______ shares and pay the same either in lump sum or in regular monthly
instalment, under the terms and conditions prescribed in the Membership Agreement;
b. Contribute a maximum of Php 200.00 (or as may be determined by the BOD) in to the share
capital; and
c. Contribute into the share capital at least ______% of the annual interest on capital (or as may be
determined by the BOD) and patronage refund due me.
4. Comply with the membership subscription agreement. Hereunder is my personal information for your
reference and consideration.
Signature over Printed Name
Name: __________________________________________________ Civil Status: ________________________
Birthplace: __________________________________________ Date of Birth: ____________________________
Present Address: ____________________________________________________________________________
Occupation: __________________________________________ Salary (Monthly) Php: ____________________
Program/Region: ______________________________________ Position: ______________________________
Office Address: _____________________________________________________________________________
Name of Father: ________________________________ Name of Mother: ______________________________
Name of Spouse (if married) : ______________________________Occupation: __________________________
Name/ Age of Children/

1. __________________________________________________________
2. __________________________________________________________
3. __________________________________________________________

This is to certify that this application for membership was approved / disapproved by the Board of
Directors in its meeting on ________________________________, 20 ____
Membership No. ____________________

The undersigned hereby offers to subscribe for the capital share as approved by the BOD of the HLURB
Multi-Purpose Cooperative set forth in this Subscription Agreement.
By execution of this Subscription Agreement, the undersigned hereby acknowledges that the
undersigned understands and agrees to comply with its obligations as follows:



To comply with the provisions of the Articles of Incorporation, the By-laws, the policies set by the
Board, the General Assembly, as well as the acts/directives of duly constituted authorities, and that,
failure on my part to do so, the HLURB Multi-Purpose Cooperative at its option, may:
a) Fine,
b) Suspend, or
c) Expel me from membership, whereupon my liabilities to the HLURB Multipurpose
Cooperative (if any) shall be chargeable against my shareholdings.
To attend all meetings, conferences and seminars as required by the Board of Directors
and failure on my part to do so, unless previously excused by the Board, to pay the fine
of Php. _______ or as may be determined by the BOD.
To pay the membership fee of Php. 200.00 (or as may be determined by the BOD).
To participate in the thrift and savings program of the cooperative by:
a) Subscribing for at least ______ shares valued at __________ (Php. ________ )
and paying for the subscribed shares either in lump sum or in regular installment,
to pay at least the value of one share on or before the organizational meeting
and the balance upon approval by the Board of my application for membership,
in regular monthly installment of ___________________________ (Php. ________ ).
b) Contributing to the share capital a maximum of Php. 200.00 (or as may be determined by the
BOD); and
c) Contributing at least one percent (1%) of every regular loan granted and at least
___ % of the annual interest on capital (or as may be determined by the BOD)
and patronage refund due me.

By affixing my signature below, I am fully aware and understood the provisions of this Agreement, the
Articles of Incorporation and By-laws, and agree to abide by the abovementioned conditions as well as the
imposition of sanctions against me in case of commission of acts not in accordance or against the said provisions.
In witness hereof, I have hereunto affixed my signature and right hand thumb mark this
_____ day of____________________ 20 ____ .

Signature over Printed Name
Accomplished: __________________________
Right Thumb Mark