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DETAILS OF CONFERENCE PARTICIPANTS

Company:
Contact Person:
Designation:
Address:
E-mail:
Phone:
Fax:

Please reg ister the following delegate/s:

 
Full Name
Designation
E-mail Address

REGISTRATION FEE PER DELEGATE

For International

Regular
USD 1,050
Exhibitor/Supporting
Organization/NGOs
USD 550

For Locals

Regular
PHP 17,500
Exhibitor/Supporting
Organization/NGOs
PHP 12,000

GROUP DISCOUNT

One (1) additional complimentary seat for every six ( 6 ) paying delegates from the same company.

Registration fee includes full participation at the Conference, conference materials, lunch, coffee breaks and networking cocktail.

We enclose our cheque/bank draft for the sum

Please note: (1) Full payment is to be m ade along with the registration . (2) All payments are to be made payable to Leverage Interna tional (Consultants) Inc. (3) The registration can be made by way of this form or similar letter.

EXHIBITOR'S AUTHORIZED SIGNATORY

PRINT NAME & SIGNATURE
DATE
Please e-mail or fax signed Application Form to the Secretariat: LEVERAGE INTERNATIONAL
Tel: (+632) 818-6828; 810-1389 Fax: (+632) 810-1594 E-mail: leverage @leverageinternational.com