Form 1
KOREAN ARTISTS ORGANIZATION OF PHILIPPINE FAN CLUBS
70D 7C Ilaya Street, Alabang, Muntinlupa City, Philippines
Application No. _____________
Date Filed _____________
APPLICATION FOR ACCREDITATION
OF FAN CLUB
Instructions:
Fill out this form and submit together with all the requirements to:
kopfa.membership@gmail.com
General Information:
1.
2.
3.
4.
5.
Purpose of Application
New
/ Renewal
Name of Applicant _Sherilyn E. Catura
_______________________________
Address __28 G. Bunyi Street, Buting, Pasig City ____________________________________
Contact Numbers: Telephone No. _79561603
_ Mobile No. _09178915370_ ______
Email address (fanclub): _philljsfans@gmail.com __________________________________
Fan Club Information:
1. Name of Fan Club _Lee Jong Suk Fans Philippines_____________________________
2. Website (If any) _______________________________________________________
3. Social Media Site Accounts
Facebook _facebook.com/ljsfansphilofficial Twitter @LJSFansPhil____________
Instagram @ljsfansphilippines____________ Weibo LSFansPhilippinesOfficial__
Others (Please specify) ________________________________________________________
4. Date Founded _June 30, 2015_____________________________________________
5. Other Affiliations ______________________________________________________
______________________________________________________
______________________________________________________
Declaration:
1.
Lee Jong Suk Fans Philippines duly represented by the undersigned, hereby apply for accreditation with
the Korean Artists Organization of Philippine Fan Clubs (KOPFa) and certify that, to the best of my
knowledge, the particulars given in this application and all accompanying documents and declarations are
true and correct.
2. I hereby authorize the KOPFa to make direct inquiries and references to any person, firm, officer or
organization named in the application to verify the information submitted herein or relating to the
competence and general reputation of myself/fan club.
3. I will make myself or an authorized representative to be interviewed as and when required by KOPFa at a
time agreed upon by both parties with respect to Lee Jong Suk Fans Philippines application for
accreditation.
4. I have clearly indicated that all information rendered is to be treated in the strictest confidence.
5. I further agree that in the event I/Lee Jong Suk Fans Philippines is found to be in breach of any code of
conduct/practice or any rules, regulations, and guidelines of the KOPFa, the KOPFa reserves the right to
either suspend or withdraw Lee Jong Suk Fans Philippines accreditation for a period determined by the
KOPFa.
________________________________
Sherilyn E. Catura
Head Admin
November 8, 2020
(Date)
FOR OFFICIAL USE ONLY
Remarks:
Recommendation:
Accreditation Period:
Verified by:
Amount Paid:
Date Paid:
_____ Approved
From:
_____ Disapproved
To:
Approved by:
KOPFa Official Receipt No.
KOPFa Officer Name & Signature: