NSOLL Contact Tracing Form
APRIL 1, 2021 - 6:00pm PRE-REGISTRATIONKindly fill up this form in line with the government directives. Maraming Salamat po sa pagtugon.
Complete Current Address
House number, Street, Barangay, City
State / Province
Postal / Zip Code
Mobile / Phone Number
Please enter a valid phone number.
Must be answered after your body temperature has been checked by the security personnel at NSOLL parish entrances.
I hereby authorize the National Shrine of Our Lady of Lourdes to collect and process the data indicated herein for the purpose of contact tracing effecting control of the COVID-19 transmission. I understand that my personal information is protected by RA 10173 (Data Privacy Act of 2012) and that I am required by RA 11469 (Bayanihan to Heal as One Act) to provide truthful information. I also understand that this form will be destroyed after 30 days of the date of accomplishment following the National Archives of the Philippines protocol.
Should be Empty: