Department of Agriculture

Bureau of Agricultural Research

RDMIC Bldg., Elliptical Rd. Cor. Visayas Ave., Diliman, Q.C. 1104
Phone Nos.: (632) 928-8624 & 928-8505  Fax: (632) 920-0227

Review of DA-BAR Funded Projects under the CPAR Program

March 11-13, 2019

CONFIRMATION SLIP

Name of Participant w/ Signature: ___________________________________________________________________

Agency: ____________________________________________________________________________________________________
Email: __________________________________________ Cellphone No.: _________________________________________
Date & Time of Arrival: _________________________________________________________________________________
Date & Time of Departure: _____________________________________________________________________________
I need Accommodation from ____________________ to _______________________. (Please indicate dates)

Name of Participant w/ Signature:____________________________________________________________________

Agency: ____________________________________________________________________________________________________
Email: __________________________________________ Cellphone No.: _________________________________________
Date & Time of Arrival: _________________________________________________________________________________
Date & Time of Departure: _____________________________________________________________________________
I need accommodation from ____________________ to _______________________. (Please indicate dates)

_______ I will not be able to attend the review but I will send a representative.

Name of the Representative w/ Signature: __________________________________________________________

Agency: ____________________________________________________________________________________________________
Email: __________________________________________ Cellphone No.: _________________________________________
Date & Time of Arrival: _________________________________________________________________________________
Date & Time of Departure: _____________________________________________________________________________
I need accommodation from ____________________ to _______________________. (Please indicate dates)

Please return the accomplished Confirmation Slip on or before February 22, 2019 thru fax or email at the below
mentioned contact details.

Fax no. (02) 920-0227 – PMED

Ms. Amavel Velasco – avelasco.bar@gmail.com