Accreditation Status

APPLICATION FOR ACCREDITATION



(Form PRA-MKT-2007-001)

This online accreditation form is for new applicants only. For renewal of accreditation, you may download the form by clicking here , fill it out and submit it to the PRA office along with the other requirements for the renewal of accreditation.


* Required Fields.
Please select one:
Active Living Facility Assisted Living Facility Marketer Merchant Partner Project Investor
Company Name*
Company Address * (No Post Office Box please)
Year Established *
City *
Postal Code *
Country *
Website *
Company Email *
Contact Number*
Other Contact Number
Fax

Contact Person
Last Name *
First Name *
Middle Name
Telephone *
Mobile
Fax
Email *

Do you have an existing company in the Philippines? Yes None
Company Address in the PHILIPPINES * (No Post Office Box please)
Year Established *
City *
Postal Code *
Province *
Website *

Please indicate products or services provided (Maximum only 3 categories will be accepted):
Accounting Services and / or Systems
Advertising, Publications, Printing
Architects
Auto repair
Barber or Beauty Shop
Bathing Equipment and /or Supplies
Beds, Bedding, Mattresses
Catering, Food Services
Computers, Software
Construction, Renovation
Dental Services
Education & Training Programs
Electrical
Financing, Financial Institutions
Funeral Homes, Cemeteries
Furniture, furnishings
Healthcare / Home Care Staffing & Services
Heating, Air-Conditioning, Ventilating Systems
Home Appliances & Repair
Hospital
Housekeeping Services and / or Supplies
Infection Control
Information Technology
Insurance
Interior Design
Laboratory Services
Landscaping & Gardening
Laundry Service
Legal Services
Massage Therapists
Medical Care & Services
Medical Services
Moving & Storage
Office Equipments
Pest Control
Pharmaceuticals
Plumbing
Real Estate Appraisers
Real Estate Broker/Marketer
Real Estate Developer
Restaurants
Safety Inspections
Security & Safety Systems
Security Agency
Signage
Spa
Transportation Services
Travel & Tours
Others:

Please check amenities offered:
24-hr room service; tray service to suites
Air conditioned rooms
Airport shuttle
Ambulance
Badminton or Squash
Banquet facilities
Beachfront
Beauty/barber shop
Bike or hiking trail
Children playground
Concierge
Conference or function room
Convenience or grocery store
Church or chapel
Dining facility or restaurant
Games room or Bingo
Golf course
Health club or gym
Hospital
Indoor parking
Indoor pool
Internet access
Laundry Service
Library
Medical clinic
Mountain biking
Non-smoking rooms
Outdoor pool
Outside parking
Pets allowed
Pharmacy
Picnic area
Postal outlet
Racquetball
Satellite or cable TV
Shuttle service. Transportation to appointments or outings.
Spa and massage
Tennis
Valet parking
Water sports
Wheelchair accessible

Please check health and personal services offered:
Assistance with activities of daily living, e.g. grooming, dressing, bathing, etc
Specialized Alzheimer Care
Convalescent Care
Day Program
Emergency Response System
Friendly Visiting
Housekeeping
Incontinence Management
Daily meals and snacks, special diets accommodated
Medication Management
Nursing Care
Occupational Therapy
Oxygen
Palliative Care
Psycho-Social Rehabilitation
Physiotherapy
Rehabilitation Care
Registered Nurse On Staff
Respite Care
Special or Intensive Care Unit
Speech Therapy
24-hour Supervision
Telephone Reassurance

Please provide a 50-word or less description of your company's products or services.

How did you learn about the PRA?
PRA Website Brochure PRA Newsletter Newspaper Magazine Friends, families, or associates TV Marketer Other Website Others. Please specify:

By affixing my signature, I hereby certify that the
information above are true and correct and that any
misrepresentation on my part will be ground for denial
of this application:
Signature of Applicant
Date Signed
PRA Use only:
Processed by: ________________________
Date signed: ________________________
Recommended for
Approval: _________________________
Date signed: _________________________
APPROVED: _________________________
Date signed: _________________________