ExpertMD under BREX Review Center, Inc.
4/F New World Bldg, Paredes cor Morayta St., Manila 1x1
Unit 1203 España Towers, España Blvd., Manila
Contact: 09777251334 (Globe) 09616827724 (Smart) Landline (02) 2304739
ONLINE REGISTRATION FORM
For FINAL COACHING MARCH 2023PLE
To register KINDLY SEND THIS FILE TO: expertmdreview@gmail.com
Name (Last Name, First Name, MI):
Age:
Sex:
Address:
Birthplace:
Mobile No:
Email:
Medical School:
Hospital of Internship (if applicable
Contact Person and No in case of Emergency:
SUBJECTS/PROGRAM TO BE ENROLLED: Final coaching
TERMS AND CONDITIONS:
1.The ONLINE review program shall be delivered in accordance with the scope set .
[ ] P6500 for non- expertMD students
[ ] P5300 for expertMD retakers who enrolled full package
[ ] P6000 for expertMD enrollees who are first takers who availed any package
[ ] P6000 for expertmd retakers who availed combo, all basics or all clinicals only
- Early bird discount of 300 pesos plus 200 peso discount if you will share our fb post for final
coaching( good for all any type of final coaching package)
- Early bird deadline: JAN 15, 2023
- Please send a proof(picture) that you shared the fb post for final coaching to get additional 200
peso discount.
- DP: P2,500 to be made upon enrollment
Full payment: Full payment on JAN 30, 2023
FINAL COACHING: starts on FEB. 22, 2023
2. The center reserves the right to modify program details as to schedule, facilities, lecturers etc,
whenever needed, with the objective of better service to the students.
3. The center reserves the right to use the name and/or photo of the undersigned for marketing purposes
in case he/she passes and/or tops the licensure exam.
4. ALL parts of ANY review material (hardcopy and digital copy) are protected with a copyright. Any form
of reproduction without permission will be subjected to legal action.
5. Enrolment to the center is voluntary and from your free will, and was not imposed by any external body.
6. The center ALLOWS REFUND made 3 days after payment.
7. During health crisis, the center will observe all precautionary measures and maintain a “Health and
Safety First” conduct.
8. The center is not responsible for any loss of personal belongings, accidents, health-related problems
on the whole duration of the program as safety precautions must be observed at all times by individuals.
I hereby certify that the above-mentioned information is true and correct. Moreover, I hereby agree to the
above-mentioned terms and conditions, and subject myself to the rights, privileges, benefits, and
responsibilities inherent upon these terms.
Sign above Printed Name
In case you cannot affix an electronic signature, IN ADDITION TO SENDING THIS ONLINE
FORM, kindly PRINT this form, accomplish it completely, and MANUALLY sign your name. THEN
TAKE A PHOTO OF THE FORM then SEND THE FILE to us (either JPEG or PDF format)
Again, if you have an electronic Signature- just send this online form
If no electronic signature- send this online form AND send the printed (with sign) file (JPEG or PDF)
INSTRUCTIONS:
1. Completely fill out this file.
2. Send this file to expertmdreview@gmail.com
3. WE ONLY HAVE VERY LIMITED SLOTS, so to reserve a slot kindly
settle your payment directly to our company treasurer.
Payment details (for GCASH, ONLINE BANKING OR OTC)
BDO Account
Christopher Rey L. Dacanay
ACCT. # 012830008762
Or at
Payment details :ONLINE BANKING AND OTC)
BDO Account (Checking)
EXPERTMD REVIEW SPECIALISTS REVIEW CENTER
ACCT.# 012838001052
4. Send a proof of payment with YOUR NAME to
expertmdreview@gmail.com
5. See you soon Doc!
