PPHA Registration Form
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This document is a registration form for the 2010 National Convention of the Philippine Pharmacists Association to be held from April 7-9, 2010 at the Leyte Park Hotel in Tacloban City. It requests information such as name, chapter affiliation, contact details, and registration fee from participants. Early bird and pre-registration fees are listed, as well as the on-site fee. Payment can be made in cash, check, or bank transfer. Contact information is provided for the PPhA Secretariat.
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![PHILIPPINE PHARMACISTS ASSOCIATION, INC.
2010 National Convention
Leyte Park Hotel, Tacloban City
April 7-9, 2010
REGISTRATION FROM
I. Participant
Title [ ] Prof. [ ] Dr.
[ ] Mr. [ ] Mrs. [ ] Ms.
Family Name : ____________________________________
First Name : ____________________________________
Middle Name : ____________________________________
Chapter/Affiliation:
Mailing Address: [ ] Office [ ] Home
____________________________________
____________________________________
Contact Number [ ] Office [ ] Home [ ] Mobile
_____________________________________
E-mail Address : ____________________________________
II. Registration Fee [ ] Delegate
Early Bird (until February 28, 2010) Php 3,000.00
Pre-Registration ( until March 30, 2010) Php 3,200.00
On-Site Php 3,500.00
2010 PPhA Membership fee Php 500.00
III. Mode of Payment [ ] Cash [ ] Check [ ] Bank Transfer
• Check payable to PHILIPPINE PHARMACISTS ASSOCIATION
• Security Bank Corporation – Mendiola Branch C/A 341-020561-002
• If payment made thru Bank transfer please fax or e-mail to PPhA Secretariat the
accomplished registration form and the deposit slip.
PPhA Secretariat Telefax: 02-3130850
PPhA E-mail Address: ppha_org@yahoo.com & philpharma@surfshop.net.ph
Address: Philippine Pharmacists Association Bldg., 815 R. Papa Street, Sampaloc, Manila](https://image.slidesharecdn.com/philippinepharmacistsassociationregistrationform-100308025548-phpapp01/85/PPHA-Registration-Form-1-320.jpg)
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选择实体注册公司办理，更放心，更安全！我们的承诺：可来公司面谈，可签订合同，会陪同客户一起到教育部认证窗口递交认证材料，客户在教育部官方认证查询网站查询到认证通过结果后付款，不成功不收费！
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- 1. PHILIPPINE PHARMACISTS ASSOCIATION, INC. 2010 National Convention Leyte Park Hotel, Tacloban City April 7-9, 2010 REGISTRATION FROM I. Participant Title [ ] Prof. [ ] Dr. [ ] Mr. [ ] Mrs. [ ] Ms. Family Name : ____________________________________ First Name : ____________________________________ Middle Name : ____________________________________ Chapter/Affiliation: Mailing Address: [ ] Office [ ] Home ____________________________________ ____________________________________ Contact Number [ ] Office [ ] Home [ ] Mobile _____________________________________ E-mail Address : ____________________________________ II. Registration Fee [ ] Delegate Early Bird (until February 28, 2010) Php 3,000.00 Pre-Registration ( until March 30, 2010) Php 3,200.00 On-Site Php 3,500.00 2010 PPhA Membership fee Php 500.00 III. Mode of Payment [ ] Cash [ ] Check [ ] Bank Transfer • Check payable to PHILIPPINE PHARMACISTS ASSOCIATION • Security Bank Corporation – Mendiola Branch C/A 341-020561-002 • If payment made thru Bank transfer please fax or e-mail to PPhA Secretariat the accomplished registration form and the deposit slip. PPhA Secretariat Telefax: 02-3130850 PPhA E-mail Address: ppha_org@yahoo.com & philpharma@surfshop.net.ph Address: Philippine Pharmacists Association Bldg., 815 R. Papa Street, Sampaloc, Manila