REGISTRATION FORM

(Please fill out or print legibly and submit or email to cdandanevents@gmail.com)

NAME: _________________________________________________________ Celebrations*Education*Commemorations*Socials*Promotions*Advertisements

First Name M.I. Last Name

DESIGNATION/OCCUPATION: ______________________________________
SCHOOL:_________________________________________________________
ATTENTION
CONTACT NUMBER:_______________________________________________
ADMINISTRATORS, TEACHERS,PARENTS,
COMPANY EMAIL:_________________________________________________ THERAPISTS, CAREGIVERS, SOCIAL WELFARE
PERSONAL EMAIL:_________________________________________________ WORKERS, BSED/BSSpEd STUDENTS &
____________________________
INTERESTED INDIVIDUALS
Signature over printed name
Notes:
1. Seminar Fee Regular Rate = P600 (inclusive of meal and seminar kit)
Learn More About
Seminar Fee for Students (Discounted) = P500 (inclusive of meal and

1.
2.
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seminar kit)
20% Discount on Early Registration made not later than Sept. 15, 2010
Payment modes: Direct Bank Deposit or Cash Payments/On-site Registration.
For Direct Bank Deposit, kindly take note of the following account particulars:
SPECIAL
Account name: Claire Dandan-Buenaventura

5.

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Account number: 128908163
Please DO NOT FORGET to indicate your name and name of your school on the
bank -validated-deposit slip and email a copy to c d a n d a n e v e n t s @ g m a i l . c o m
Upon our receipt of your deposit slip, a copy of your Acknowledgment Receipt
EDUCATION
will be emailed to you. Present the AR copy at the Registration Table on the
seminar date to receive the Original Receipt. with Mr. Francis A. Buenaventura
IMPORTANT: If you do not receive our AR thru email, call us at once at Occupational Therapist/Special Education Teacher
0915.357.2915 to avoid delays and inconveniences during the
seminar registration.

September 19, 2010

1:00 to 5:00 P.M.
Celebrations*Education*Commemorations*Socials*Promotions*Advertisements

Block 15 Lot 40 Southern City I Cellphone : 0915.357.2915

the CHiLDReN’s LiBRaRY
Tanzang Luma IV, Imus, Cavite 4103 Phone: 046.543.8063 4/F Robinsons Place Imus, Gen. E. Aguinaldo Highway,
E - mail: c d a n d a n e v e n t s @ g m a i l . c o m Tanzang Luma, Imus, Cavite