Membership Application Form Please fill out the membership form below completely and accurately. Fields marked with an asterisk (*) are required. Make sure to provide a valid email address and mobile number so we can send you updates and confirmation. For dropdown menus, select the most accurate option that applies to you. The Zip Code field will be filled in automatically based on your selected Province and Town. If a field does not apply to you, simply enter "N/A". Once you have completed the form, click the Submit button and wait for the confirmation message to ensure your application has been successfully received. Personal Information Last Name First Name Middle Name Suffix No. & Street Baranggay Province Municipality Zip Code Date of Birth * required Age Place of Birth Gender Contact No. Email Education & Employment Educational Attainment Employment Status Source of Funds School Course Please Specify Please Specify Employer/Business Name Occupation Title/Position Company/Business Address Contact Number Gross Monthly Income Nature of Employment/Business Please Specify Marital Status Civil Status Last Name First Name Middle Name Suffix Date of Birth Age Place of Birth Nature/Type of Employment/Business Place of Work Dependents Full Name Full Name Birth Date Age Birth Date Age Beneficiaries Full Name Full Name Select a date * required Select a date * required Age Age Relationship Relationship Father's Profile Last Name First Name Middle Name Birth Date Employment Status Mother's Profile Last Name First Name Middle Name Birth Date Employment Status Supporting Documents 2x2 Picture Upload File Upload supported file (Max 15MB) Front ID Upload File Upload supported file (Max 15MB) Back ID Upload File Upload supported file (Max 15MB) Your Signature Clear I hereby confirm that I have read, understood, and agreed to the following Terms and Conditions of Mother Rita Multi-Purpose Cooperative. I accept terms & conditions Share Capital Agreement I with legal age is hereby applying for membership with Mother Rita Multi-Purpose Cooperative and agrees to comply with the policy set forth by the cooperative as stated in the articles of cooperation and by-laws and the resolutions approved by the Board of Directors and General Assembly. I hereby promise to pay my initial Paid Up Share Capital Common/Preferred Share Capital Subscription amounting to TEN THOUSAND PESOS (P 10,000.00) in full or in installment basis for one year. Further, no instance shall my common/preferred share be withdrawn while I am still a a member of the Cooperative, instead it shall regularly be deposited. I agree Data Privacy Consent By submitting this application, I voluntarily consent to the collection, use, and processing of my personal data by Mother Rita MPC for membership verification, communication, and cooperative-related purposes, in accordance with the Data Privacy Act of 2012. I agree Submit Thanks for submitting!

Laboratory Cooperative for youth and Aflatoun. EMPOWERING THE YOUTH Mother Rita Laboratory Cooperative A dynamic organization for minors within the Province of Zambales, designed to foster leadership, financial literacy, and cooperative values among the youth. Affiliated with the Mother Rita Multipurpose Cooperative, this initiative aims to prepare young individuals for responsible citizenship and future roles in the cooperative sector. Governed by Special Guidelines: Mother Rita Laboratory Cooperative operates under special regulations set forth by the Cooperative Development Authority (CDA) in accordance with Republic Act No. 9520 and its implementing rules. These guidelines ensure that our young members receive the proper training, guidance, and supervision from experienced members of the Mother Rita Multipurpose Cooperative, creating a safe and nurturing environment for personal growth. Join Us in Building the Future of Cooperativism! Mother Rita Laboratory Cooperative is where the youth of today grow into the cooperative leaders of tomorrow. What We Offer: Youth Leadership Training: Equip minors with essential skills in leadership, decision-making, and teamwork. Financial Literacy: Introduce members to basic financial management and cooperative principles. Community Building: Promote a strong sense of community and cooperative spirit among the youth. Guided by Registered Guardians: Supervised by the Mother Rita Multipurpose Cooperative, ensuring a safe and structured environment. THE YOUTH WE SERVE Based on the categories defined by the National Youth Commission, Mother Rita Cooperative Youth Leadership program focuses on the following sub-sectors: In School Youth (Basic Education and College Level) Out of School Youth -Below 12 (those who should be in school) -12-18 (those who should be in school) -18-25 (youth who should be in college or working) Working Youth (Underemployed, Employed, Entreprenuer) LabCoop in ACTION Be a member of the Mother Rita Laboratory Cooperative Apply Now Do you want to teach your children FINANCIAL LITERACY? check this out A school and community-based savings advocacy, social and financial education program. View More

Online Membership Application Online Membership Registration Personal Details First Name * Date of Birth * Gender * Gender Middle Name * Last Name * Age * Place of Birth Citizenship * Citizenship Civil Status * Civil Status Weight Height kg Name Suffix Name Suffix Other Citizenship Citizenship ft Educational Attainment Educational Attainment School Name Degree/Course No. / St./ Zone Subd/Brgy/Dist * Province * Province City / Municipality * Zip Code * City/Municipality Cellphone # * Telephone # Email Address * Employment / Business Details Primary Source of Income * Primary Source of Income Secondary Source of Income Other Source of Income Major Occupation * Major Occupation Sub Occupation * Sub Occupation Employer / Business Name Employer / Business Address Title / Position Zip Code Employer / Business Contact # Work Shift Gross Monthly Income * Gross Monthly Income Gross Annual Income * Pre-Membership Details Date of Membership * Account Classification * Entry * Classification Type of Member * Remarks Member Type Date of Orientation Conducted On Status Area Code Conducted By Spouse Details Full Name * Date of Birth Complete Present Address Same with Personal Address Employer / Business Name Contact Occupation Occupation Gross Annual Income Gross Annual Income Parent's Datails Father's Full Name Date of Birth Occupation Occupation Home Address Mother's Maiden Name * Date of Birth Occupation Occupation Home Address Same with father Select how Many Dependent/s you want Select Dependent/s (Optional) Select how many Beneficiary/ies you want Select Beneficiary/ies (Optional) 1st Dependent's Detail Dependent's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 2nd Dependent's Detail Dependent's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 3rd Dependent's Detail Dependent's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 4th Dependent's Detail Dependent's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 5th Dependent's Detail Dependent's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 1st Beneficiary Beneficiary's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 2nd Beneficiary Beneficiary's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 3rd Beneficiary Beneficiary's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 4th Beneficiary Beneficiary's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 5th Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address Same as Personal Address Supporting Documents Upload a photo of self with Clear Background and Proper Attire * Upload a Photo Have your E-Signature Here * Upload any government Issued Id * Front * Upload a ID (Front) Back * Upload a ID (Back) Clear Share Capital Agreement I with legal age is hereby applying for membership with Mother Rita Multi-Purpose Cooperative and agrees to comply with the policy set forth by the cooperative as stated in the articles of cooperation and by-laws and the resolutions approved by the Board of Directors and General Assembly. I hereby promise to pay my initial Paid Up Share Capital Common/Preferred Share Capital Subscription amounting to * in full or in installment basis for one year. Further, no instance shall my common/preferred share be withdrawn while I am still a a member of the Cooperative, instead it shall regularly be deposited. Select Subsription * - Agree * I hereby confirm that I have read, understood and agreed to the following Terms and Conditions of MORIMC. Agree * _ Submit Application

Online Membership Application Online Membership Registration Personal Details First Name * Middle Name * Last Name * Name Suffix Name Suffix Date of Birth * Gender * Gender Educational Attainment Educational Attainment Age * Place of Birth Citizenship * Citizenship Civil Status * Civil Status Weight Height kg Other Citizenship Citizenship ft School Name Degree/Course No. / St./ Zone Subd/Brgy/Dist * Province * Province City / Municipality * Zip Code * City/Municipality Cellphone # * Telephone # Email Address * Employment / Business Details Primary Source of Income * Primary Source of Income Secondary Source of Income Other Source of Income Major Occupation * Major Occupation Sub Occupation * Sub Occupation Employer / Business Name Employer / Business Address Title / Position Zip Code Employer / Business Contact # Work Shift Gross Monthly Income * Gross Monthly Income Gross Annual Income * Pre-Membership Details Date of Membership * Account Classification * Entry * Classification Type of Member * Remarks Member Type Date of Orientation Conducted On Status Area Code Conducted By Spouse Details Full Name * Date of Birth Complete Present Address Same with Personal Address Employer / Business Name Contact Occupation Occupation Gross Annual Income Gross Annual Income Parent's Datails Father's Full Name Date of Birth Occupation Occupation Home Address Mother's Maiden Name * Date of Birth Occupation Occupation Home Address Same with father Select how Many Dependent/s you want Select Dependent/s (Optional) Select how many Beneficiary/ies you want Select Beneficiary/ies (Optional) 1st Dependent's Detail Dependent's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 2nd Dependent's Detail Dependent's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 3rd Dependent's Detail Dependent's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 4th Dependent's Detail Dependent's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 5th Dependent's Detail Dependent's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 1st Beneficiary Beneficiary's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 2nd Beneficiary Beneficiary's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 3rd Beneficiary Beneficiary's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 4th Beneficiary Beneficiary's Full Name Date of Birth Age Relationship Home Address Same as Personal Address 5th Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address Same as Personal Address Supporting Documents Upload a photo of self with Clear Background and Proper Attire * Upload a Photo Have your E-Signature Here * Upload any government Issued Id * Front * Upload a ID (Front) Back * Upload a ID (Back) Clear Share Capital Agreement I with legal age is hereby applying for membership with Mother Rita Multi-Purpose Cooperative and agrees to comply with the policy set forth by the cooperative as stated in the articles of cooperation and by-laws and the resolutions approved by the Board of Directors and General Assembly. I hereby promise to pay my initial Paid Up Share Capital Common/Preferred Share Capital Subscription amounting to * in full or in installment basis for one year. Further, no instance shall my common/preferred share be withdrawn while I am still a a member of the Cooperative, instead it shall regularly be deposited. Select Subsription * - Agree * I hereby confirm that I have read, understood and agreed to the following Terms and Conditions of MORIMC. Agree * _ Submit Application

OF/OFF, Regular Savings, Time Deposits, Special Savings Deposits, Fixed Deposit, ATM Deposits, Savings Bond, Aflatoun Savings, Paluwagan, Progressive Savings, Pondong Edukasyon Savings Account, Progressive Savings, Retirement Fund Program, Fixed Deposits AWARDS & RECOGNITIONS FIXED INVESTMENTS IN STOCKS COMMON SHARE CAPITAL Minimum Share Capital: ₱10,000.00 payable in 1 year. Passbook Residence of Pangasinan, Zambales and Bataan Interest Rate: Dividend Declaration Must be 1% higher than the inflation rate. Php 500.00 membership fee INCLUSIVE OF INSURANCE GADDI Interest Distribution: Month of April after Annual General Assembly PREFERRED SHARE CAPITAL Maximum of 2 years to complete the subscribe share capital-prefferred. Residence of Pangasinan, Zambales and Bataan Interest Rate: Interest on Share Capital Distribution 3% per annum Interest Distribution: Month of April after Annual General Assembly

MAIN OFFICE Lauis, Candelaria, Zambales Contact No.: +63 9989622781 Email: morimc16eru@yahoo.com MASINLOC OFFICE Masinloc Mall, Masinloc, Zambales Contact No.: +63 9209499803 CABANGAN OFFICE Brgy. San Antonio, Cabangan, Zambales Contact No.: +63 9517619293 STA. CRUZ OFFICE Poblacion North, Sta. Cruz, Zambales Contact No.: +63 9985103163 IBA OFFICE Zone 6, Iba, Zambales Contact No.: +63 9701771323 BRANCH OFFICE San Guillermo, San Marcelino, Zambales Contact No,: +63 9088922889 Email: morimc_micoop@yahoo.com SUBIC OFFICE Calapacuan, Subic, Zambales Contact No.: +63 9088966938

ONLINE MEMBERSHIP APPLICATION PERSONAL INFORMATION FIRST NAME * DATE OF BIRTH * required * GENDER * MIDDLE NAME PLACE OF BIRTH CIVIL STATUS SURNAME * SUFFIX AGE WEIGHT KG. HEIGHT FT. CITIZENSHIP DUAL CITIZENSHIP EDUCATIONAL ATTAINMENT PROVINCE * ZIP CODE SCHOOL NAME MUNICIPALITY * BARANGAY * CELLPHONE NO. * TELEPHONE NO. COURSE STREET/ZONE/DISTRICT EMAIL ADDRESS * EMPLOYMENT / BUSINESS INFORMATION PRIMARY SOURCE OF INCOME EMPLOYER / BUSINESS NAME SECONDARY SOURCE OF INCOME EMPLOYER / BUSINESS ADDRESS MAJOR OCCUPATION TITLE / POSITION SUB OCCUPATION ZIP CODE OTHER SOURCE EMPLOYER / BUSINESS CONTACT GROSS MONTHLY INCOME GROSS ANNUAL INCOME SPOUSE INFORMATION FULL NAME PRESENT COMPLETE ADDRESS DATE OF BIRTH CONTACT NO. SPOUSE OCCUPATION EMPLOYER / BUSINESS NAME GROSS MONTHLY INCOME PARENT'S INFORMATION FATHER'S FULL NAME DATE OF BIRTH * required OCCUPATION HOME ADDRESS Same w/ Personal Address MOTHER'S MAIDEN NAME MOTHER'S DATE OF BIRTH * required MOTHER'S OCCUPATION HOME ADDRESS Same w/ Father's Address SUPPORTING DOCUMENTS UPLOAD 2X2 PICTURE Upload File Upload supported file (Max 15MB) * ID FRONT COPY Upload File Upload supported file (Max 15MB) * ID BACK COPY Upload File Upload supported file (Max 15MB) * E-SIGNATURE Clear SHARE-CAPITAL AGREEMENT I with legal age is hereby applying for membership with Mother Rita Multi-Purpose Cooperative and agrees to comply with the policy set forth by the cooperative as stated in the articles of cooperation and by-laws and the resolutions approved by the Board of Directors and General Assembly. I hereby promise to pay my initial Paid Up Share Capital Common/Preferred Share Capital Subscription amounting to * in full or in installment basis for one year. Further, no instance shall my common/preferred share be withdrawn while I am still a a member of the Cooperative, instead it shall regularly be deposited. Select Subscription I agree I hereby confirm that I have read, understood and agreed to the following Terms and Conditions of MORIMC. I agree SUBMIT APPLICATION Thank you! We received your submission

Online Membership Registration Personal Details First Name * Middle Name * Date of Birth * Age * Place of Birth Last Name * Name Suffix Name Suffix Citizenship * Citizenship Sex * Sex Civil Status * Civil Status Educational Attainment Educational Attainment School Name Degree/Course No. / Street / Zone Subdivision/Barangay/District * Province * Province City / Municipality * City/Municipality Zip Code * Cellphone # * Telephone # Email Address * Weight kg Height ft Employment / Business Details Primary Source of Income * Secondary Source of Income Major Occupation * Primary Source of Income Other Source of Income Major Occupation Sub Occupation * Sub Occupation Employer / Business Name Employer / Business Address Title / Position Zip Code Employer / Business Contact # Work Shift Gross Monthly Income * Gross Monthly Income Gross Annual Income * Pre-Membership Details Date of Membership * Account Classification * Classification Entry * Type of Member * Remarks Member Type Membership Orientation Date * Orientation Conducted On Conducted By Status Area Code Spouse Details Full Name * Date of Birth Complete Present Address Same with Personal Address Contact Occupation Occupation Employer / Business Name Gross Annual Income Parent's Datails Father's Full Name Date of Birth Occupation Occupation Home Address Mother's Maiden Name * Date of Birth Occupation Occupation Home Address Same with father Select how Many Dependent/s you want Select Dependent/s (Optional) Select how many Beneficiary/ies you want Select Beneficiary/ies (Optional) 1st Dependent's Detail Dependent's Full Name Date of Birth Relationship Home Address Same as Personal Address Age 2nd Dependent's Detail Dependent's Full Name Date of Birth Relationship Home Address Same as Personal Address Age 3rd Dependent's Detail Dependent's Full Name Date of Birth Relationship Home Address Same as Personal Address Age 4th Dependent's Detail Dependent's Full Name Date of Birth Relationship Home Address Same as Personal Address Age 5th Dependent's Detail Dependent's Full Name Date of Birth Relationship Home Address Same as Personal Address Age 1st Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address Same as Personal Address Age 2nd Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address Same as Personal Address 3rd Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address Same as Personal Address Age 4th Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address Same as Personal Address Age 5th Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address Same as Personal Address Share Capital Agreement I with legal age is hereby applying for membership with Mother Rita Multi-Purpose Cooperative and agrees to comply with the policy set forth by the cooperative as stated in the articles of cooperation and by-laws and the resolutions approved by the Board of Directors and General Assembly. I hereby promise to pay my initial Paid Up Share Capital Common/Preferred Share Capital Subscription amounting to Ten Thousand Pesos (10,000.00) in full or in installment basis for one year. Further, no instance shall my common/preferred share be withdrawn while I am still a a member of the Cooperative, instead it shall regularly be deposited. I with legal age is hereby applying for membership with Mother Rita Multi-Purpose Cooperative and agrees to comply with the policy set forth by the cooperative as stated in the articles of cooperation and by-laws and the resolutions approved by the Board of Directors and General Assembly. I hereby promise to pay my initial Paid Up Share Capital Common/Preferred Share Capital Subscription amounting to Ten Thousand Pesos (10,000.00) in full or in installment basis for one year. Further, no instance shall my common/preferred share be withdrawn while I am still a a member of the Cooperative, instead it shall regularly be deposited. I Agree * I hereby confirm that I have read, understood and agreed to the following Terms and Conditions of MORIMC. Terms and Condition I Agree * _ Submit Application

Online Membership Registration Personal Details First Name * Middle Name * Date of Birth * Age * Place of Birth Last Name * Name Suffix Name Suffix Citizenship * Citizenship Sex * Sex Civil Status * Civil Status Educational Attainment * Educational Attainment School Name/Degree/Course No. / Street / Zone Subdivision/Barangay/District * Province * Province Secret Province City / Municipality * City Secret City/Municipality Zip Code * Cellphone # * Telephone # Email Address * Weight kg Height ft Employment / Business Details Primary Source of Income * Primary Source of Income Secondary Source of Income Other Source of Income Occupation * Occupation Employer / Business Name Employer / Business Address Title / Position Zip Code Employer / Business Contact # Work Shift Gross Monthly Income * Gross Monthly Income Gross Annual Income Pre-Membership Details Date of Membership * Account Classification * Classification Entry * Type of Member * Remarks Member Type Search Membership Orientation Date * Orientation Conducted On Conducted By Status Area Code Spouse Details Full Name * Date of Birth * Complete Present Address Same with Personal Address Contact Occupation * Occupation Employer / Business Name Gross Annual Income Parent's Datails Father's Full Name Date of Birth Occupation Occupation Home Address Mother's Maiden Name * Date of Birth Occupation Occupation Home Address Same with father Select how Many Dependent/s you want Select Dependent/s (Optional) Select how many Beneficiary/ies you want Select Beneficiary/ies (Optional) 1st Dependent's Detail Dependent's Full Name Date of Birth Relationship Home Address Age 2nd Dependent's Detail Dependent's Full Name Date of Birth Relationship Home Address Age 3rd Dependent's Detail Dependent's Full Name Date of Birth Relationship Home Address Age 4th Dependent's Detail Dependent's Full Name Date of Birth Relationship Home Address Age 5th Dependent's Detail Dependent's Full Name Date of Birth Relationship Home Address Age 1st Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address Age 2nd Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address 3rd Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address Age 4th Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address Age 5th Beneficiary Beneficiary's Full Name Date of Birth Relationship Home Address Create User Name * Create New Password Confirm Password Alternate Email Address Secret Question #1 Secret Question #1 Secret Question #2 Secret Question #2 Supporting Documents Upload a photo of self with Clear Background and Proper Attire * Upload any government Issued Id (Front and Back) * Upload a Photo Have your E-Signature Here * Upload a ID (Front) Upload a ID (Back) Clear Share Capital Agreement I with legal age is hereby applying for membership with Mother Rita Multi-Purpose Cooperative and agrees to comply with the policy set forth by the cooperative as stated in the articles of cooperation and by-laws and the resolutions approved by the Board of Directors and General Assembly. I hereby promise to pay my initial Paid Up Share Capital Common/Preferred Share Capital Subscription amounting to Ten Thousand Pesos (10,000.00) in full or in installment basis for one year. Further, no instance shall my common/preferred share be withdrawn while I am still a a member of the Cooperative, instead it shall regularly be deposited. I Agree * Submit Application

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Mother Rita MPC Partners and Networks. Network and Linkages MOTHER RITA MPC partners with trusted organizations to help co-ops better serve their members.