AQRA Membership Form
AIIAS, Lalaan I, Silang, Cavite, Philippines
Renewal -- Silver (P500 or USD15) yearly
New -- Silver (P500 or USD15) yearly
New -- Gold (P5000 or USD150) for lifetime membership
Renewal -- Gold (P5000 or USD150) for lifetime membership
AQRA ID# (only for existing members)
Referred by (only for new members):
Highest Academic Degree
Doctorate in Progress
Major Fields of Expertise
Preferred Complete Address
Alternate Email Address
Cell Phone #
Alternate Cell Phone #
Current Primary Status
How Did You Hear About AQRA?
Facebook/other social media
By submitting this form, I agree to (1) pay the membership fee using this link:
and (2) email the scanned copy of my proof of payment to
as soon as payment is made. I understand that I must add 5% charge if I pay online.
Watch our AQRA Video
Send me a copy of my responses.
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