Subscription Agreement Form RY 2015-2016

Club Subscription Agreement / 2015-16
MAGAZINE OF CHOICE
OFFICIAL REGIONAL MAGAZINE OF ROTARY INTERNATIONAL
Member, Rotary World Magazine Press
PUBLISHER : PHILIPPINE ROTARY MAGAZINE FOUNDATION, INC.
Date _______________
Rotary Club of __________________________________________________
District __________________
Total number of active members as of the latest Semi-Annual Report (SAR) [dated _________________ ] *
Less : 1) No. of current semester’s subscriptions to The Rotarian magazine (TR)
_______________
2) No. of Lifetime Subscribers from this Rotary Club
_______________
3) No. of Joint Subscriber/s (see note below**)
_______________
Total deductions (total of 1, 2 & 3 above)
* PLS. ATTACH ALL PAGES OF LATEST SAR TO PERSONALIZE EACH COPY; SEE NOTE 5 BELOW
Subscription to the Philippine Rotary Magazine (put this figure in the no. of members below)
NOTE : RI requires Rotary magazine (PRM/TR) subscription for every active Rotary club member **
A _______________
B ( ______________ )
A LESS B _______________
 TOTAL DUE FOR ONE YEAR: One Year subscription from July 2015 to June 2016 @ P 540.00/member x ______ member/s
PAYMENT OPTIONS (choose one):
 One Year (July 2015 to June 2016) @ P 540.00/member x ______ member/s
FOR SEMESTRAL PAYMENT
 First Semester (July 2015 to December 2015) @ P 270.00/member x ______ member/s
 Second Semester (January 2016 to June 2016) @ P 270.00/member x ______ member/s***
*** DUE ON DECEMBER 1, 2015
 UNPAID SUBSCRIPTIONS (PAST SEMESTER/S)
PER PRM LATEST BILLING DATED _____________
 MAILING COST (for individually mailed copies only) SEE NOTE 4 BELOW
P30.00 / issue x _____ issues (6 or 12) x _____ member/s
TOTAL PAYABLE TO THE PHILIPPINE ROTARY MAGAZINE FOUNDATION, INC.
P____________________
P____________________
____________________
____________________
____________________
____________________
PAYMENTS ARE APPLIED FIRST TO UNPAID OBLIGATIONS FOR THE PAST SEMESTER/S BEFORE THEY ARE APPLIED TO THE CURRENT SEMESTER’S SUBSCRIPTION.
P
 PAYMENT MODE : (checks payable to “PHILIPPINE ROTARY MAGAZINE FOUNDATION, INC.”)
 Cash
 Check : Bank _________________ Chk. no. ___________________
 Deposited with any Bank of the Philippine Islands Branch (for credit to Philippine Rotary Magazine Foundation, Inc. account no.
3371-0064-93 with BPI - Congressional-Visayas Ave., Quezon City Branch) - validated deposit slip attached. Please indicate your
five-digit Rotary club number as bank reference number.
**Per 2010 RI Manual of Procedure, “two Rotarians residing at the same address have the option to subscribe jointly to the official magazine”. Indicate on this space the number of paired joint subscriber/s (e.g.
if there is one pair of Rotarians in the same address, the number is “1”; if there are two pairs, the number
is “2”; and so on.) For record purposes, pls. indicate the names & addresses of the joint subscribers
below (use another sheet if there are more than one joint subscriptions.)
Joint#1 : name#1 ___________________________ name#2 ________________________________
Joint Addrs ________________________________________________________________________
 PLEASE SEND COPIES IN BULK TO:
Name : _____________________________________
Address :____________________________________
___________________________________________
Important reminders:
1. Subscribe and pay for all club members at the start of each semester. One year subscription is required; semestral payments are accepted.
2. For payments thru Bank of PI, please write your Rotary club name & contact no. on the BPI validated deposit slip
and send it with this form WITHIN 24 HOURS by email to [email protected]. This ensures proper recording of
your deposit payment.
3. Please make checks payable to “Philippine Rotary Magazine Foundation, Inc.”. Only local or regional checks
are accepted. For Rotary clubs located outside of local or regional clearing areas, please pay in demand draft /
Manager’s Check drawn on a Metro Manila branch of your bank.
4. Copies will be delivered in bulk via courier service. Copies individually mailed locally will be charged a mailing
fee of P30.00 (Metro Manila or Provincial) per issue per member.
5. PRM can personalize each copy of the magazine. Just send us together with this form the complete list of club
members’ names or all the pages of the latest SAR.
6. Letters may be addressed to PDG Melito Salazar, Jr., Editor-in-chief.
NOTE : Club Subscription to The Philippine Rotary Magazine &/or The Rotarian
must equal the number of members in the SAR, except if the club has joint subscriptions. Unpaid subscriptions, even for past Rotary year/s, must be settled
by the club before the end of this first semester. Non-subscription or non-payment of subscription by a club are grounds for termination of RI membership.
_______________________________
President Club Secretary, RY 2015-16
Signature over printed name
Address:
_____________________________________
_____________________________________
Tel. / CP nos. __________________________
Fax no. ______________________________
Email _______________________________
For any inquiries, please contact:
Call tel nos. 416-3800 • 332-5729 (telefax)
GF Rotary Center Bldg. Roces cor. Mo. Ignacia Avenue
Quezon City 1103 • e-mail : offi[email protected]
FOR PRM USE ONLY / DO NOT FILL UP:
RECEIVED BY : _________________ DATE : _________
___FAXED ___MAILED ___HANDCARRIED
REMARKS _______________________________________
Revised 20 Feb. 2015