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REGULAR ASSOCIATE INDIVIDUAL MOTORSPORTS3-YEAR REGULAR 3-YEAR ASSOCIATE INDIVIDUAL PIDP ASSOCIATE GROUP NO. OF CARS______
NOTE: Private, light and non-commercial vehicles only
*Submit photocopy of the car registration (O.R and C.R)
MEMBERSHIP CATEGORIESNOTE: Private, light and non-commercial vehicles only
CAR MAKE/MODEL YEAR COLOR FUEL TYPE 1st
2nd
PLATE NO. CONDUCTION STICKER NO.
GASDIESELGASDIESEL
HOME ADDRESS
COMPANY NAME
ADDRESS
HOME PHONE COMPANY PHONE FAX NO.
CELL PHONE EMAIL ADDRESS
CONTACT INFORMATIONCONTACT INFORMATION
MR. MS. MRS. LAST NAME FIRST NAME MIDDLE NAME
BIRTHDATE BIRTHPLACE
SEX CIVIL STATUS AGE MALE FEMALE
CITIZENSHIP OCCUPATION
PERSONAL INFORMATIONAAP MEMBERSHIP APPLICATION FORM
PAID Php ______________________________ CASH PAYMENT CREDIT CARD
BPI’s CHECK FREE PAYMENTS Visit www.bpiexpressonline.com or call 89-100
PAY THROUGH BANCO DE ORO (INSTITUTION CODE # 0136) Upon teller’s validation, BDO payment slip serves as your official receiptt
CHECK PAYMENTS (Payable to Automobile Association of the Philippines, Inc.) DATE _____________________________________ BANK ____________________________________ ACCOUNT NO. _____________________________
BANCNET ONLINE PAYMENT (For Online Applications Only)
PAYMENT MODE
SOURCE: REG ERS RDL PIDP SALES BRANCH ____________________________________________ OTHERS ___________________________________ AAP I.D. NO. _________________________________________ AMOUNT PAID ______________________________ INSURANCE NO. ______________________________________ O.R. NO. ___________________________________
FOR AAP USE ONLY SOURCE: REG ERS RDL PIDP SALES BRANCH ____________________________________________ OTHERS ___________________________________ AAP I.D. NO. _________________________________________ AMOUNT PAID ______________________________ INSURANCE NO. ______________________________________ O.R. NO. ___________________________________
SOURCE: REG ERS RDL PIDP SALES BRANCH ____________________________________________ OTHERS ___________________________________ AAP I.D. NO. _________________________________________ AMOUNT PAID ______________________________ INSURANCE NO. ______________________________________ O.R. NO. ___________________________________
SOURCE: REG ERS RDL PIDP SALES BRANCH ____________________________________________ OTHERS ___________________________________ AAP I.D. NO. _________________________________________ AMOUNT PAID ______________________________ INSURANCE NO. ______________________________________ O.R. NO. ___________________________________
SOURCE: REG ERS RDL PIDP SALES BRANCH ____________________________________________ OTHERS ___________________________________ AAP I.D. NO. _________________________________________ AMOUNT PAID ______________________________ INSURANCE NO. ______________________________________ O.R. NO. ___________________________________
SOURCE: REG ERS RDL PIDP SALES BRANCH ____________________________________________ OTHERS ___________________________________ AAP I.D. NO. _________________________________________ AMOUNT PAID ______________________________ INSURANCE NO. ______________________________________ O.R. NO. ___________________________________
DATE APPLICANT’S SIGNATURE
REGISTERED CARS
