1 / 2

Philippine Society for Developmental and Behavioral Pediatrics (PSDBP)

Philippine Society for Developmental and Behavioral Pediatrics (PSDBP) 6th Biennial Convention: Looking In and Linking Up. REGISTRATION FORM. September 9-10, 2011 EDSA Shangri La Hotel, Mandaluyong City. Please check :. MD. SP. OT. PT. SPeD Teacher.

blaine
Télécharger la présentation

Philippine Society for Developmental and Behavioral Pediatrics (PSDBP)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Philippine Society for Developmental and Behavioral Pediatrics (PSDBP) 6th Biennial Convention: Looking In and Linking Up REGISTRATION FORM September 9-10, 2011 EDSA Shangri La Hotel, Mandaluyong City Please check: MD SP OT PT SPeD Teacher Primary Hospital Affiliation/Therapy Center/School Teacher Parent Other: _________ LAST NAME Primary Practice Address FIRST NAME M.I. PRC NUMBER REGISTRATION FEE: Pre-Registration : Php 3000 On-Site Registration: Php 3500 Deadline for Pre-Registration: June 30, 2011 To Register, call 02-434-3946 or email: devpedphil@gmail.com Manner of Payment: Cash/Personal Check (for Pre-Registration Only) payable to PSDBP Or Deposit to PSDBP current account: BPI Family Bank, P. Tuazon, Cubao Branch (Account # 6015-0599557) For more information: Contact RJ Palor (PSDBP Secretary) +639228019057 or at 02-4343946 4th Floor Philippine Pediatric Society (PPS) Bldg, 52 Kalayaan Avenue, Barangay Malaya, Quezon City Nickname: ________ Specialty ___________ Subspecialty ______ Medical Society/Affiliation: ________________________________ Mailing Address: ________________________________________ ______________________________________________________ Mobile Number ___________________ Landline______________ Email Address: _________________________________________

  2. Philippine Society for Developmental and Behavioral Pediatrics (PSDBP) 6th Biennial Convention: Looking In and Linking Up REGISTRATION FORM September 9-10, 2011 EDSA Shangri La Hotel, Mandaluyong City Please check: MD SP OT PT SPeD Teacher Primary Hospital Affiliation/Therapy Center/School Teacher Parent Other: _________ LAST NAME Primary Practice Address FIRST NAME M.I. PRC NUMBER REGISTRATION FEE: Pre-Registration : Php 3000 On-Site Registration: Php 3500 Deadline for Pre-Registration: June 30, 2011 To Register, call 02-4343946 or email: devpedphil@gmail.com Manner of Payment: Cash/ Personal Check (for Pre-Registration Only) payable to PSDBP Or Deposit to PSDBP current account: BPI Family Bank, P. Tuazon, Cubao Branch (Account # 6015-0599557) For more information: Contact RJ Palor (PSDBP Secretary) +639228019057 or at 02-4343946 4th Floor Philippine Pediatric Society (PPS) Bldg, 52 Kalayaan Avenue, Barangay Malaya, Quezon City Nickname: ________ Specialty ___________ Subspecialty ______ Medical Society/Affiliation: ________________________________ Mailing Address: ________________________________________ ______________________________________________________ Mobile Number ___________________ Landline______________ Email Address: _________________________________________

More Related