License Application Form
Application Type
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New License
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Licensee Name
Sports
Role
Lincense Number
Status
Action
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Applicant Information
Division
*
Pro-Basketball & Other Pro-Games Division
Boxing and Other Contact Sports Division
Horse Racing Betting Supervision Division
Sport
*
Applying license for
*
Last Name
*
First Name
*
Middle Name
Suffix
Nickname/Alias
Address Type
Local (Philippines)
Foreign
Home Address
*
Local Address (Philippines)
Region
*
Select Region
Province
*
Select Province
City/Municipality
*
Select City/Municipality
Barangay
*
Select Barangay
Street Name
*
House/Unit No., Floor, Building
Lot/Block No., Phase/Subdivision/Village
Sitio/Purok (if applicable)
Zip code
*
Country
State/Province/Region
City
Postal Code
Street address
Contact No.
Office Address
Telephone No.(office)
Date of Birth
*
Place of Birth
Age
Gender
*
Male
Female
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Citizenship
*
Civil Status
*
Married
Widowed
Separated
Divorced
Single
Height
*
Weight
*
Club/Organization/Team Affiliation
*
League
*
Additional Information
Educational Background
*
Choose
Elementary Level
High School Level
College School Level
Are you currently under any management or managerial contract
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Have you been denied by a License GAB
Have you been accused or convicted of any crime? (if yes, state the nature of offense)
List of Requirements
Medical Requirements
Please compile all the medical requirements on one PDF file only. (Max. 10mb file size)
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Signature
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Signature
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