Join Shell Club15 Plus Now! Shell Club15 Plus, Inc. Membership Application Form Step 1 of 3 33% Eligibility Requirements Please ensure you meet the eligibility requirements: Only Shell Regular employees who left Shell service within the last five (5) years are eligible to apply for Regular or Associate Membership. Regular staff still employed by Shell are eligible to apply as Regular members only. Applicants for Associate Membership must secure the endorsement of three (3) Regular Members in good standing. To assist you, please click this LINK to access the official endorsement template. Submit the accomplished endorsement together with this application form. *Regular Members – Minimum 15 years of continuous or cumulative service within the Shell Group of Companies.* Associate Members – employed by Shell for less than 15 years but with a minimum of 10 years in service. Former employees of other companies within the Shell Group who have made the Philippines as their domicile. If you do not meet the eligibility requirements, click here to exit this page. Otherwise, click Next to proceed with your application. I am applying for:*Regular MembershipAssociate Membership Download the official Shell Club15+ endorsement template here.Accomplished Endorsement Form 1*Accomplished Endorsement Form 2*Accomplished Endorsement Form 3* Important: Before completing the webform below with your personal information, please read the following carefully, and confirm that you understand, agree, consent, or certify by marking the corresponding tick boxes for each of the subject headings below: Please note that the system will not allow you to submit the application form if all the boxes are not properly marked. On Data Privacy Shell Club15 Plus (SC15+) is committed to honouring and safeguarding your privacy. We will process the personal information you will provide in accordance with the Data Privacy Act (DPA) of 2012, its implementing rules and regulations and other applicable laws. Should your application not be approved, then all the personal data you supplied will not be stored in our systems and will be deleted immediately. For more information on how your personal information will be processed, your rights as a data subject and the rationale behind the steps involved, please visit the SC15+ Data Privacy Policy at https://shellclub15.com/privacy-policy/ * I hereby understand and agree to the processing of the personal information I will submit, in accordance to the DPA. I further understand that, as a data subject, that I can exercise the above rights under the DPA.*On Your Role as a Club Member As a member of the club you can attend our discussion series, attend club events and socials, vote during the AGMM (for regular members only), and can be qualified for grants under our Good Samaritan Fund. Members are expected to: Participate in Club activities whenever possible. Respond to Club communications and surveys. Keep contact information updated. Volunteer from time to time. Maintain active membership. It is also your duty to inform the Secretariat of any changes in your contact details so that we can communicate with you regularly. Should you not attend any of the several events of the club for a period of 2 consecutive years without any valid reasons, or should you no longer be contactable for a period of 2 years, then we will take it that you are no longer interested to become a member and will take your case to the Board of Trustees for the appropriate action. * I hereby understand and agree to the roles that I will take as a club member. *Current Employment or Profession* I hereby certify that I am not actively engaged in the manufacturing and/or marketing of petroleum fuels (liquid or gas), lubricants and/or in competition with the Shell Group of Companies, either as a principal, partner or employee.*Declaration on Criminal Convictions * I hereby certify that I have not been convicted of any crime involving moral turpitude.*Please complete the membership application form below. The system will automatically send the accomplished form in PDF to the Shell Club15 email address for the approval of your application by the Board of Trustees. You will be notified of the status of your application by The Secretariat accordingly.Last Name*First Name*Middle Name*Nickname*Date of Birth(Birthdate) Month*JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember(Birthdate) Day*12345678910111213141516171819202122232425262728293031(Birthdate) Year*Present Address*Mobile No.*Email Address*Civil Status*Select OneSingleMarriedWidowedName of Spouse*Shell Employment Status*Still with ShellRetiredWhen did you join Shell?(Date Joined Shell) Month*Choose OneJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember(Date Joined Shell) Year*When did you leave Shell?(Date Left Shell) Month*Choose OneJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember(Date Left Shell) Year*Current/Last Position in Shell*Current/Last Department in Shell*Years of Service*Please enter a number from 1 to 100.Reason for Application*Field of Specialization/Profession*Present Employer/Nature of BusinessHave you, after leaving Shell, worked for or owned a business that directly competes with Shell in petroleum fuels, lubricants, or related businesses?*YesNoIf yes, please provide name of company, start and end dates , and role or position in the company.Name of CompanyRole or PositionStart Date MM DD YYYY End Date MM DD YYYY Contact Person in Case of Emergency*Contact Number in Case of Emergency*Photo*Accepted file types: jpg, jpeg, gif, png, pdf.Please attach a recent photo of yourself.On the veracity of the information you provided* I hereby certify that the information provided herein is true and correct which may be validated by the Club. I declare that these are voluntarily given by me for the exclusive use of the Shell Club15 Plus, Inc. for the purpose of processing my membership application to the Club. *On the storage of your personal information* I agree that the Club may store my information until such time that I cease to be a member thereof which may be brought about by expulsion, resignation or death. *On your consent to the sharing of your information* I further give my consent to the sharing of the above information by the Club to any of its affiliates, agents, representatives or assigns but only with respect to the furtherance of my membership in the said Club. Other than that, the Club must first obtain my consent before sharing my information to anybody else. ** I agree to abide by the rules and decisions of Shell Club15 Plus, Inc.*EmailThis field is for validation purposes and should be left unchanged.