I hereby consciously submit this application for consideration for membership to MDKO which is a voluntary non-profit organization. I declare under penalty of Perjury in in the United States on this day of that:

  1. The information provided in any part of this application is correct and accurate as of the date of signing.
  2. That I have read the Constitution and by-laws of the MDKO and agree to be bound by them and any other applicable law.
  3. That I understand that this is an application for membership which the MDKO has the discretion to approve my membership or not.
  4. That I understand that I will pay the membership application fee of US $250 which will be deposited to the MDKO benevolence account. I also understand that I will pay the annual membership fee of $50 payable annually. The acceptance of this fee does not guarantee acceptance into membership and should my application be declined I shall receive a full refund of my application fee. This fee shall be refunded together with the written decision declining my membership with or without reason for such decision. Any interest, if any from the membership application fee shall be applied towards any administrative costs of adjudicating your application and the MDKO shall not be required to itemize these costs.
  5. If any form of payment is declined, MDKO shall charge $35 per declined transaction and this shall become a debt due to MDKO immediately.
  6. That it is my responsibility to inquire from my relatives as to their membership to MDKO. I understand and agree that MDKO shall only make a single payment where there is an occurrence of a covered event. Should there be more than one person making a similar claim to the MDKO for a certain single covered event, it shall be the responsibility of all the covered members (relatives) to advise the MDKO as to the manner of disbursement. of the benevolent funds.
  7. That I understand as an MDKO member my contributions shall remain due at all times until I cease membership. As an applicant I will submit this application form together with the application fee of US$250 which is reviewable. This fee shall be deposited into the benevolence fund. There shall be an additional Annual membership renewal fee of $50 paid on first day of July each year. The application shall be accepted only during the open enrollment period which will be from July 1st to July 31st. The Membership shall run from July 1st to July 31st of the following year.
  8. That I understand the recoupment shall be within seven (7) days of notice by the Committee of benevolent assistance and it shall be 20 dollars for protected family member and $50 for active member. But this amount can change depending on number of members registered. Thus, amount will be decided by the Organization or the Committee from time to time and communicated together with the notice of benevolent assistance and recoupment request.
  9. That I understand and agree that failure to recoup within the first14 days after the announcement, a fine of twenty dollars ($20) will be levied on the 14th day. In addition, failure to recoup within thirty days (30) days shall affect the entitlement to member’s benefit including benevolent assistance.
  10. I understand that, notwithstanding the condition 7 above, should I receive any financial assistance from MDKO, I shall be bound to continue contributing towards any occurrence that may take place within one (1) year of my assistance even if I cease being a member.
  11. That I particularly know and understand how I would cease being a member of MDKO and that coverage starts 90 days from the registration date.
  12. That MDKO Board members will at its discretion verify any reported death. I agree to submit all requested documents, including but not limited to death certificate, burial permit, and copy of Identity Card (ID) before the funds have been disbursed depending on the request. The information in the government issued document must match with the details provided to MDKO during registration; including and not limited to date of birth, names, etc. In event of a death you have up to 90 days to provide the death certificate while the burial permit and copy of ID may be provided within 5 days of reporting of the said death.
  13. That any member(s) who does not recoup after 30 days, waives their right to benevolence assistance from the organization for the next 30 days from the day they recoup. A member who does not recoup for 90 days after a case is reported, his/her membership will terminate on the 90th day.
  14. By submitting my registration application, I agree to abide by all MDKO rules and regulations.