Form No. 02 Ref. No.

_______
Rev.00/09-27-10

APPLICATION FOR REGISTRATION OF

FIRM/PARTNERSHIP/ASSOCIATION/CORPORATION
IN THE PRACTICE OF LANDSCAPE ARCHITECTURE

1. Name of Individual Landscape Architect/Firm/Partnership:

_____________________________________________________________________

2. Full Name of Sole Practitioner/ LA License Position in the

Partners Number Firm/Partnership

__________________________ ________________ _______________

__________________________ ________________ _______________
__________________________ ________________ _______________
__________________________ ________________ _______________

3. SEC Certificate of Registration No.________________________________________

(if a registered partnership)

4. Complete Address of Principal Office:______________________________________

5. Tel. No. ________________________ Fax No. _____________________________

6. Website of principal office _______________________________________________

7. Website of branches ____________________________________________________

8. E-mail address ________________________________________________________

9. Branches/Sub-Offices, if any: ____________________________________________

___________________________________________________________________

10. Full Name of Staff LA Certificate APEC Registry Position in the

Members Number Number Firm/Partnership

___________________ __________ _____________ ________________

___________________ __________ _____________ ________________
___________________ __________ _____________ ________________
___________________ __________ _____________ ________________
___________________ __________ _____________ ________________
___________________ __________ _____________ ________________

11. Full Name of Principal, if any LA Certificate Position in the

Number Firm/Partnership

____________________________ ____________ _________________

____________________________ ____________ _________________
12. Correspondent Relationship with Foreign LA/ LA Firm, if any:

Name of Foreign Firm Name of Foreign Nature and Extent

Country of Relationship

________________________ __________________ __________________

________________________ __________________ __________________

13. Changes in the Firm/Partnership from Last Registration: _______________________

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

14. Internal Quality Review Procedures _______________________________________

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

I hereby certify that the foregoing entries/information are true and correct

_______________
Date
_______________
Place
___________________
Managing Partner

Sole Practitioner

ACKNOWLEDGEMENT

Republic of the Philippines ) S.S.

City of ________________ )

Personally appeared before me ___________________________with his/her Community

Certificate No._______________issued at _______________on _______________
known to me and to me known to be the same person who executed the foregoing
instrument and acknowledge the same to be his/her free voluntary act and deed.

NOTARY PUBLIC

Doc. No. ________

Page No. ________
Book No.________
Series of ________

Note: Use additional sheet where necessary which must be certified as true and correct or
attach plantilla of partner and staff members