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Excellence.
PHILIPPINE INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS
REGISTRATION FORM
INFORMATION
LAST NAME FIRST NAME MIDDLE NAME NICKNAME SEX
Check No.
* subject to the availability of slots.
Date of Check
NOTE
PAYEE:
1. Venue can only accommodate 500 participants. On-site
registration will only be allowed if slots are available. PICPA SURIGAO DEL SUR CHAPTER
2. Cancellation or Refund will only be entertained until Feb.15, 2019, Deposit To:
with an administrative fee of 20% of paid registration fee. Philippine National Bank - Bislig City Branch
3. Please ensure that this form is clearly and completely filled up. Current Account no.: 4004-1001-4727
Potential CPD Credits: 24 Units, subject to the approval of the Professional Regulation Commission (PRC)
Email or send the completed form and proof of payment (i.e. deposit slip) to: Tel. Nos. 0916-591-4328 - Tess Taripe
0998-966-2815 - Melody Patiño
CONVENTION SECRETARIAT:
0920-958-2166 - Raquel Bautista
PICPA Bislig Chapter 0946-851-9944 - Irine Georfo
Bislig City