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REGISTRATION FORM
Last Name First Name Middle Name Nickname Sex
After August 31, 2017 to Nov. 21, 2017 Php 8,500 Php 9,500
Payee: 72nd PICPA Annual National Convention
On-site registration - Nov. 22, 2017 Php 10,000 Php 12,000 Deposit to: BDO Stanford Shaw Blvd., Mandaluyong Branch
Foreign delegate US$ 250 US$ 300 Current account number 002810098952
Sessions Slots are limited. Early Registration with payment is strongly advised
Note: Please ensure that this form must be clearly and completely filled up. Registration will be valid only upon receipt of fully completed form and payment of the registration
fee. Cancellation or refund will be entertained only until September 15, 2017, with administrative fee of 20% of paid registration fee. Please fax or email your validated deposit
slip with your name and CPA number to the Convention Secretariat. Earn up to 27 CPD units by attending all sessions from Nov 22 to 25! Earn more by participating in
optional activities like passing the online assessments on technical sessions attended, submission of articles, and others, for up to potentially double the CPD
credit units.
Grand entertainment awaits you on the opening ceremony and fellowship nights!
Please send, email or fax the completed form to the Convention Secretariat at PICPA MMR Secretariat, GF PICPA Building, 700 Shaw Blvd., Mandaluyong City.