REGISTRATION FORM

CPD Seminar

National Seminar-Workshop on Work Attitude and Values Enhancement

CPD No. 2017-072-298
August 4, 2018 at TSU-Alumni Center, Villa Lucinda Campus, Tarlac City

Participants’ Profile

Name of Participants Sector/Company/ Contact No. PRC License Expiry Age Amount Paid Deposit Slip Reference
Organization Number Date No. / O.R. No.

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Registration Fee: (PhP 1,200.00)

The inclusions are as follows:

 Lunch and AM and PM Snacks
 Training Kit
 Certificate
PAYMENT PROCESS AND ISSUANCE OF OFFICIAL RECEIPT

Through DBP Bank (Please refer to the banking details of TSU-ESO below)

BANK NAME ACCOUNT NAME ACCOUNT NO.

Development Bank of the Philippines (DBP) TSU-PRODUCTION PHP 0550-034-417-030

After depositing, send us a copy of your deposit slip and registration form at the extension@tsu.edu.ph and wait for the slot confirmation of the CPD
Provider. Take note that the Official Receipt will be given on the day of the seminar.

Over the Counter Payment

At the assessment window (located at TSU Accounting Office, Admin Building, Main Campus), present your registration form. Then, proceed to the TSU
cashier window (located at the back of the TSU Admin Building, Main Campus) for the payment. Send us copy of your registration form and Official Receipt at
extension@tsu.edu.ph and wait for the slot confirmation of the CPD Provider.

For inquiries, please contact the Continuing Professional Development Providers:

Dr. Maria Agnes P. Ladia Mr. Jo-Andrew G. Agustin

Program Head, Professional Development Administrative Aide II, UESO
Services 0925-6501-502 0919-9101-233
Note : Kindly settle your payment on or before June 24, 2018 . For participants with confirmed slot, only 80% of the registration
fee will be refunded if the cancellation is requested 5 days before the seminar. Any late payment and walk-in participants will not
be entertained.