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JBC SALESPERSON'S ACCREDITATION FORM

PERSONAL INFORMATION

First Name

Middle Name

Last Name

Nickname

Birthdate

Age

Gender

Select gender

Civil Status

Select civil status

Nationality

Filipino

Other...

Address

Area

Select area

Mobile Number 1

Mobile Number 2

Facebook Account/Page

Email Address

ACADEMIC INFORMATION

Post-Graduate Academic Year

Post-Graduate Course

Post-Graduate School / University

College Academic Year

College Course

College School / University

High School Academic Year

High School School / University

Elementary Academic Year

Elementary School / University

EMERGENCY CONTACT

Emergency Contact Name

Emergency Contact Number

Relationship to Applicant

Select an Option

CONTACT REFERENCE

Note: Contact reference must not be a family member or relative.

Reference Name

Reference Contact Number

Relationship to Applicant

Select an Option

RULES AND REGULATIONS

The following agreements are required. You will not be able to submit this form without accepting both.

I have read and agree to follow the Rules and Regulations of JBC Marketing and Development OPC.

REQUIREMENTS

Kindly upload files

A. Applicant's 1x1 or 2x2 Picture

Upload a clear 1x1 or 2x2 photo (JPG or PNG, max 1MB)

No Choosen File

(Max 1 MB)

B. 2 Valid IDs

Upload 2 Valid IDs (JPG, PNG or PDF)

No Choosen File

(Max 1MB per ID)

Accepted Valid IDs: Passport, Driver's License, SSS ID, GSIS ID, PhilHealth ID, Pag-IBIG ID, Postal ID, Voter's ID, National ID (PhilSys), PRC ID, NBI Clearance, Police Clearance, Barangay ID, Senior Citizen ID, PWD ID, School ID (for students), or any government-issued ID.

DECLARATION

I confirm that, to the best of my knowledge, the information provided by me in this form is correct and complete. I have read and understood the instructions clearly agree and to abide by all the rules and regulations.

Applicant's Signature

Date Signed

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JBC SALESPERSON'S ACCREDITATION FORM

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