FILAMPGH Registration – Filipino American Association of Pittsburgh

Individual/Family Registration Form

Please use this form to create an account if you are registering for Individual Membership or Family Membership as the Family Manager

First Name *

Display Name

Nickname

User Password *

Birth Month *

Street Address

Postal Code

Country

Last Name *

Phone Number *

Email *

Confirm Password *

Birth Year *

City

State/Province/Region

Where in the Philippines were you originally from?

What Filipino Language do you speak?

Facebook Name (for our members only Facebook group)

Referred By

Would You Like to Add a First Family Member? *

Family Member 1 First Name *

Family Member 1 Birth Month *

Family Member 1 Email (Has to be different than primary email)

Would You Like to Add a Second Family Member? *

Family Member 1 Last Name *

Family Member 1 Birth Year *

What is the family member's relationship with the plan manager? *

Family Member 2 First Name *

Family Member 2 Birth Month *

Family Member 2 Email (Has to be different than primary email)

Would You Like to Add a Third Family Member? *

Family Member 2 Last Name *

Family Member 2 Birth Year *

What is the family member's relationship with the plan manager? *

Family Member 3 First Name *

Family Member 3 Birth Month *

Family Member 3 Email (Has to be different than primary email)

Family Member 3 Last Name *

Family Member 3 Birth Year *

What is the family member's relationship with the plan manager? *

Media Release

I/We hereby grant the Filipino American Association of Pittsburgh, Inc. and its representative, agents, and assigns, the irrevocable and unrestricted right to use, reproduce, and publish still and moving images in print, electronic, and other media of me/us, and children under my/our custodian/guardianship, including my/our image and likeness as depicted therein which are identified in photographs/videos taken at FAAP-related events, hereto, for the FAAP website, newsletter, and any other official FAAP publications, and in any manner and medium; to later the same without restriction. I hereby release the FAAP and its directors, officers, agents, legal representatives, and assigns from any and all claims, actions, and liability relating to the use of said photographs and videos.

Code Of Conduct *

As a proud member of the Filipino American Association of Pittsburgh, Inc, I wholeheartedly agree and abide by its code of conduct. By adhering to the code, I am dedicated to upholding the highest standards of ethical behavior in all aspects of my membership. This includes treating all individuals with dignity and courtesy, promoting inclusivity and diversity, and acting in the best interest of our organization and its members.

We just need basic information: