University of Cebu – College of Law

Mandatory Continuing Legal Education

A Supreme Court-Accredited MCLE Provider since 2006

Gov. M. Cuenco Ave., Banilad, Cebu City 6000 Philippines * Fax. No. (6332) 505-4978 Trunk line (6332) 233-8888 loc. 103

REGISTRATION FORM
Theme: “Legal Engagement in the Digital World“
February 16-17 & 23-24, 2018

Atty. __________________________________ , _______________________________ ___________________________

Family Name Given Name Middle Name
Date of Birth: _______________________ TIN No: ___________________________
Year Admitted to the Bar: ____________ Roll of Atty. No. : _________________ IBP Chapter: __________________
Permanent Address: ______________________________________________________________________________________
Contact No. : __________________________ E-mail: ______________________________________

Company/Office: ________________________________________________________________________________________
Office Address: _________________________________________________________________________________________
Contact No.: ______________________ Fax No.: ___________________________

Please check date(s) of MCLE Seminar that you are attending:

__ February 16, 2018 __ February 17, 2018 __ February 23, 2018 __ February 24, 2018

Registration Fee:
 Early Bird Rate [Full Course] Payment Information:
- Php 7,000 (if paid on or before January 24, 2018)
Mode of Payment: Please Check.
 Regular Rate[Full Course] __ Cash __ Check __ Bank Deposit
- Php 7,500 (if paid on January 25 to February 10, 2018)
 Senior Citizen/Alumni Rate [Full Course] Amount : P__________________
- Php 7,000 (if paid on or before February 10, 2018)
Ref. No : ______________________________
 Onsite Rate[Full Course]
- Php 8,000 (if paid on February11, 2018 onwards)
OR No : ___________________
 Rate per Day - P 3,000

Fee is inclusive of the following: AM Snack, buffet lunch, PM Snack,

flowing coffee and tea, seminar kit, lecture materials, Certificate of
Attendance, processing of Attorney’s Compliance Report and facilitation
of Certificate of Compliance with the Supreme Court – MCLE Office. ___________________________________
Signature over Printed Name / Date

Check Payment, payable to UC Legal Aid and Law Center, Inc., or deposit to Banco de Oro Account # 4938002430 and fax deposit
slip to phone no. (032) 505-4978, or email a scanned copy to ivy.ucmcle@gmail.com.