Kulasa 1996 Membership Form

The Kulasa HomePage Membership Form!

If you are a Member of Batch 1996

Just complete this form. Click on Submit when ready to send.

Your name:

Email address:

HomePage URL:

HomeAddress:**

Telephone No/s:**

** Information stated above will only be released to members of Batch 1996 with the prior consent from member concerned

Where are you studying?

University of the Philippines Diliman
University of the Philippines Manila
University of the Philippines Baguio
University of the Philippines Los Baños
Ateneo De Manila University
De LaSalle University
College of Saint Benilde
University of Sto. Tomas
University of Asia and the Pacific
Other Colleges/Universities

Other: Please Specify

Course:

Would you like to receive News when this site is updated?
Yes
No
Yes, but only if its about something important
Would you like other members of Batch 1996 to receive/view pertinent information about you??
Yes
No
Please Email me to ask for authorization

How did you find out about this site?

Any comments?

Your name:
Email address:
HomePage URL:
HomeAddress:**
Telephone No/s:**