OMSMPC Online Membership Staging |

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Personal Information

First Name (*Required)

Last Name (*Required)

Suffix

Middle Name

Date of Birth (*Required)

Civil Status (*Required)

Gender (*Required)

Religion (*Required)

Blood Type

Mobile no. (*Required)

Weight

Height

Phone no.

Email Address (*Required)

Occupation (*Required)

Social Media(optional)

Do you have dependents?

NO

YES

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Name of Dependents

Relation

Date of Birth

Occupation

Address (House no./ Street / Purok) (*Required)

Province (*Required)

City / Municipality (*Required)

Barangay (*Required)

Zip Code

Geographical Location

Mailing Address

Educ. Attainment (*Required)

Are you a lazada seller? (*Required)

Yes

No

TIN (*Required)

Seller Information

Seller ID

Shop Category

Are you a seller in other online platforms?

Yes

No

Are you managing a business?

Yes

No

Please Specify the platform

Employer

Position

Sectoral Group

Date of Employment

Other source of income

Monthly Salary

Spouse Information

Fist Name (*Required)

Middle Name

Last Name (*Required)

Suffix

Date of Birth

Gender (*Required)

Mobile no. (*Required)

Monthly Income

Occupation