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Registration Form for EdukCircle Event

This document contains a registration form for an educational program. It requests information such as the participant's name, address, date of birth, contact details, emergency contact, and registration fee details. The registration fees vary depending on the participant type (student, teacher, or non-university), when registering (early bird, regular, or late), and whether participating online or in-person. It also provides payment details needed to register and confirms the participant certifies the details provided are correct.

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Vienna Joy Banquiao
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64 views2 pages

Registration Form for EdukCircle Event

This document contains a registration form for an educational program. It requests information such as the participant's name, address, date of birth, contact details, emergency contact, and registration fee details. The registration fees vary depending on the participant type (student, teacher, or non-university), when registering (early bird, regular, or late), and whether participating online or in-person. It also provides payment details needed to register and confirms the participant certifies the details provided are correct.

Uploaded by

Vienna Joy Banquiao
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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12L El Jardin Del Presidente Tower II, 38 Sgt.

Esguerra Street, South Triangle, Quezon City, Philippines 1103


Telefax (632) 83627918 Email: edukcircle@yahoo.com

REGISTRATION FORM

Program: ___________________________

______________________________ ____________________________________________ ____________________________________________


Surname First Name Middle Name

__________________________________________________________________________________________________________
Current Address

________________________________________________ ______________________________________ __________


University/Company Course/Designation Year

____/____/_________ _____________________ ______ _________


Birth date Birthplace Age Gender

___________________ ______________________ ________________________________________________


Home Phone Mobile No. Email Address

Emergency Contact: _____________________________________________________ __________________________


Name Mobile No. (optional)

Registration Fee (non-refundable)

Students and Teachers

__ Early Bird June 01 – August 31, 2023 __P800 (online) __1,200 (in-person)
__ Regular September 01 – October 15, 2023 __P900 (online) __1,300 (in-person)
__ Late October 16 – 25, 2023 __P1,000 (online) __1,500 (in-person)
__ Members June 01 – October 15, 2023 __P700 (online) __1,000 (in-person)

Non-University Participants

__ Early Bird June 01 – August 31, 2023 __P1,000 (online) __1,300 (in-person)
__ Regular September 01 – October 15, 2023 __P1,100 (online) __1,500 (in-person)
__ Late October 01 – 15, 2023 __P1,200 (online) __2,000 (in-person)

BDO
Account Name: International Education Circle ICCS Co. Account Number: 001620183895

Inclusive of:
Authenticated e-Certificate of Participation/Request for a hard copy – P300/each for online participants
Certificate (hard copy) for in-person participants

------------------------------------------------------------------------------------------------------------------------------------------------

I hereby certify that the above details are true and correct.

______________________________ ___/___/______
signature over printed name Date

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