REGISTRATION FORM

Email to: ibonropr@gmail.com ibonrop@ymail.com

Course:
Venue: Fee:

COSH - Occupational Safety & Health for the Construction Industry and Construction Site Safety Officers (40 hours)
University Hotel, University of the Philippines, Diliman, Quezon City 10,080 9,000 per head. Regular Rate. 12% VAT Inclusive per head. PEZA &/or VAT Exempt Rate
Date, from: to

Training Dates:

X Mon to Fri Month:

Please refer to the schedule available I provided.

Name of Participant # 1 Company Name: PEZA &/or VAT Exempt Company: Yes Address: Tel No.: E-mail Address: Name of Participant # 2 Company Name: PEZA &/or VAT Exempt Company: Yes Address: Tel No.: E-mail Address: Person Authorizing Registration: Name: Designation:
Who will pay for your registration fee?

Personal No / N.A Cell 2:

Cell 1:

Personal No / N.A Cell 2:

Cell 1:

How will you pay for your registration?

Pay : Mode:

Cash

Check

Company will Pay

Personal Pay on Day 1 of training

Bank Deposit. Will fax/email copy of deposit slip.

FILL-UP and EMAIL/SUBMIT YOUR REGISTRATION FORM to reserve your slot/s. We will send you a location
map upon receipt of this Registration Form. Full payment of the registration fee may be paid on day 1 of the training seminar. If paying by check, make it payable to Synerquest Management Consultancy Services, Inc. If payment is made thru bank, BPI CA Acct # 1991-0088-68 e-mail a scanned copy of the deposit slip for verification and for our record.

Contact: Ronald Pornobi, MBA Business Development Officer

Globe: 0917-544-77-17 Smart: 0918-946-46-23 Sun: 0922-811-18-17

ibonropr@gmail.com ibonrop@ymail.com http://goo.gl/CqL3H