Title Date

PASIA MEMBER NON-MEMBER APPLYING MEMBER

CONTACT DETAILS

Company Name:

Company Address:

Name: Nickname:

Job Title: Personal / Company Email Address:

Facebook / Twitter Account:

Telephone No.: Mobile No.: 3 WAYS TO REGISTER

1. Mail the attached registration form with your cheque to: 2. Fax Registration Form to: +(632) 8448586 10/F DPC Place Bldg., 2322 Don Avenue, 3. Email to: [email protected] City 1231

MODES OF PAYMENT

CASH CHECKS Cheques payable to: Procurement and Supply Institute of Asia, Inc. (TIN: 233-296-866-000 NON-VAT) CREDIT CARD Visa Master Card

Credit Card Number: Card Name: Expiry Date: Signature:

BANK DEPOSIT You may deposit the amount at any branch of BPI in Asia’s current account details: Account Name: Procurement and Supply Institute of Asia, Inc. Account No.: C/A# 3201-0374-67 Bank Address: Bank of the Philippine Islands MCC 6750 Branch 6750 Ayala Office Tower, , Makati City 1226 Bank Swiftcode: BOPIPHMM

(Note: Kindly fax the deposit slip at +(632) 844-8586 after payment has been made for confirmation)

TERMS AND CONDITIONS 1. Submission of this form will serve as confirmation of attendance. 2. Cancellation made within (5) working days prior to the event will be charged in full amount. 3. Cancellation made on the event date is considered a confirmed attendance and registrant shall be charged in full amount 4. Substitutions may be made on or before the event. Kindly advise the secretariat for substitution. 5. Payment must be settled (10) days upon receipt of the original / electronic copy of the billing statement. 6. Interest will apply for late payment (after 10 days) * 15 days – 3% of the total billed amount * 25 Days – 4% of the total billed amount * 20 Days – 3.5% of the total billed amount * 30 Days – 5% of the total billed amount

Signature Date

TRANSPROCURE AND PASIA SHARED SERVICES SECRETARIAT 10th Floor DPC Place Building, 2322 Don , Makati City 1231, Philippines Telephone No.: +(632) 844-2680 | Fax No.: +(632) 844-8586 | www.pasia.org | [email protected]