Pactap Registration Form 2019
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2019 PACTAP National Conference-Workshop Citystate Asturias Hotel, Puerto Princesa City, Palawan March 19-22, 2019 “Paradigm Shift
Towards Globalization, Immersion with Technological Interventions”
REGISTRATION FORM LGU: ______________________________________________
Region: ___________
Department/Office: ______________________________________________________ Address: ______________________________________________________________
Name of Participant/s
Designation/Position
1. 2. 3. 4. 5. 6. Please use a separate sheet if necessary. This Registration Form can be reproduced.
Contact Person: ____________________________________ Position: ____________________ Landline/Mobile No.: _______________________ Email Add: _____________________________
Submitted by: ____________________________ Signature above Printed Name Head of Office/Department ----------------------------------------------------------------------------------------------------------------------------- -----------------------
PLEASE DO NOT FILL-IN (for Registration Committee use only) TOTAL AMOUNT PAID: P ____________
O.R. No. ________________
DATE PAID: ____________
----------------------------------------------------------------------------------------------------------------------------- -----------------------
Towards Globalization, Immersion with Technological Interventions”
REGISTRATION FORM LGU: ______________________________________________
Region: ___________
Department/Office: ______________________________________________________ Address: ______________________________________________________________
Name of Participant/s
Designation/Position
1. 2. 3. 4. 5. 6. Please use a separate sheet if necessary. This Registration Form can be reproduced.
Contact Person: ____________________________________ Position: ____________________ Landline/Mobile No.: _______________________ Email Add: _____________________________
Submitted by: ____________________________ Signature above Printed Name Head of Office/Department ----------------------------------------------------------------------------------------------------------------------------- -----------------------
PLEASE DO NOT FILL-IN (for Registration Committee use only) TOTAL AMOUNT PAID: P ____________
O.R. No. ________________
DATE PAID: ____________
----------------------------------------------------------------------------------------------------------------------------- -----------------------
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