Note:

• Please return accomplished form and payment to:
  
  Diabetes Philippines Secretarist,
  661 BONI AVENUE corner LIGAYA STREET MANDALUYONG CITY 1501
  TEL.: 531-1278 , 534-9559
  FAX: 531-1278
  Email: diabetesphilippines@pldtdsl.net
  Webiste: www.diabetesphilippines.org


• if payment was made thru bank please attach duplicate copy of your deposit slip with your application form
• Only application form accompanied by payments will be processed

MEMBERSHIP FEE: php 500.00/year

Option 1 Cash
Option 2 Bank Transfer

You may pay your membership fees at the branches of the following banks:

Authorized Banks:
Methrobank: S/A No. 254-3-25402919-0
BDO: S/A No. 004590297194

Check No. ________________ Issuing Bank __________________

Account Name: Diabetes Philippines, Inc.

Account Name: Diabetes Philippines, Inc

• Health Care Professional Application
• Lay Application
• Update Form