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NEW MEMBERSHIP APPLICATION

Please complete the application form below. Fields marked with * are required.

APPLICATION INFORMATION
Your official application reference will be generated after successful submission.
PERSONAL INFORMATION
MEMBERSHIP CLASSIFICATION
PROFESSIONAL INFORMATION
CONTACT INFORMATION
Please provide your current contact number and email address.
Mobile or telephone number.
RESIDENTIAL INFORMATION
HOSPITAL / CLINIC INFORMATION
COUNCIL MEMBERSHIP

Select up to TWO council memberships that you would like to actively participate in.

MEMBERSHIP FEE

PHP 500.00 / YEAR

Annual membership fee.

Payment Options:

Account Name: Diabetes Philippines, Inc.

PROOF OF PAYMENT
If payment was made through bank transfer, please upload your deposit slip or transfer confirmation.
Accepted file types: JPG, JPEG, PNG, PDF. Maximum file size: 5 MB.
DATA PRIVACY NOTICE

We are committed to maintaining the trust and confidence of our members, guests and visitors. We uphold the protection of personal information in accordance with the Data Privacy Act of 2012.

What do we collect?

We collect personal identification information such as name, gender, nationality and date of birth.

We also collect contact details including address, telephone number and email address.

We may collect employment and professional information necessary for membership processing.

How may we collect your data?

You directly provide most of the data collected when you register for membership, activities and other organizational services or when you voluntarily provide information to us.

How may we use your data?

We collect data to process your membership application, maintain membership records and communicate information regarding organizational activities.

Your data protection rights

Members may request copies of their personal data and may request correction of inaccurate information, subject to applicable laws and regulations.

Unless permitted or required by law, personal information will not be disclosed without appropriate authorization.

How to contact us

Diabetes Philippines, Inc.
661 Boni Avenue corner Ligaya Street
Mandaluyong City 1501
Telephone: 8531-1278 / 8534-9559

Email: diabetesphilippines@pldtdsl.net

Office Hours: Monday - Friday, 10:00 AM - 6:00 PM

Before submitting: Please review all information carefully. Once submitted, your application will be forwarded to the Diabetes Philippines Secretariat for verification.
Diabetes Philippines, Inc.
661 Boni Avenue corner Ligaya Street, Mandaluyong City 1501