RM_Stats40th National Annual Convention CITYSTATE ASTURIAS HOTEL, PUERTO PRINSESA CITY, PALAWAN April 28-30, 2020 Personal Information Note: Please write your name as it will appear on your certificate. Full Name *Company Name *Designation *Email *Region *Select an optionARMM (Autonomous Region in Muslim Mindanao)CAR (Cordillera Administrative Region)NCR (National Capital Region)Region 1 (Ilocos Region)Region 2 (Cagayan Valley)Region 3 (Central Luzon)Region 4A (CALABARZON)Region 4B (MIMAROPA)Region 5 (Bicol Region)Region 6 (Western Visayas)Region 7 (Central Visayas)Region 8 (Eastern Visayas)Region 9 (Zamboanga Peninsula)Region 10 (Northern Mindanao)Region 11 (Davao Region)Region 12 (SOCCSKSARGEN)Region 13 (Caraga Region)Mobile Number *Please enter your mobile in format of: +63xxx-xxx-xxx, ex. 917 123 4567 Company Information Company Address * Powered by GOOGLE MAPS Street Number Street Address City State Country Zip Code Authorized Person *Please enter your company's authorized representative.Company Contact Nos (Tel and Mobile) *Please enter your company's contact numbers.Company Email Address *Please enter your company's email address Convention Stubs Check all that apply * Convention Kit Stub Meal Stub Payment Details BDO Account Name: POLLUTION CONTROL ASSOC. OF THE PHILS., INC. (PCAPI) Account Number: 012130025729 METROBANK Account Name: POLLUTION CONTROL ASSOC. OF THE PHILS., INC. (PCAPI) Account Number: 007167536618 Payment Mode * Cash Check Bank Deposit Checkbox for check detail * I recognize that checks should be made payable to: POLLUTION CONTROL ASSOC. OF THE PHILS., INC. (PCAPI) Please check the box to agree.BankPlease enter Bank of check to be issued.Check NumberFor check payments, enter check number in this field.AmountAmount of check to be issued. Bill to Company Contact Person *Please enter the name of the person to contact for payment.Designation/Position *Please enter Designation/Position of contact personDepartment *Please enter the department the contact person for payments belongs toContact Numbers *Contact Numbers POLLUTION CONTROL ASSOCIATION OF THE PHILIPPINES, INC. (PCAPI) Unit 245 -247, Cityland Pioneer, Pioneer St., Mandaluyong City, 1550, Philippines Telefax. Number (02) 8584-6720, Tel Number: (02) 7747-3974 Email add: pcapi888@yahoo.com/ pcapi888@gmail.com Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
Note: Please write your name as it will appear on your certificate.
POLLUTION CONTROL ASSOCIATION OF THE PHILIPPINES, INC. (PCAPI)
Unit 245 -247, Cityland Pioneer, Pioneer St., Mandaluyong City, 1550, Philippines Telefax. Number (02) 8584-6720, Tel Number: (02) 7747-3974 Email add: pcapi888@yahoo.com/ pcapi888@gmail.com