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RegistrationForm

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CompleteName:_____________________________________________________________________________________________________
Profession:__________________________________PRCNo._____________________ExpiryDate:________________________________
Institution/Company:_________________________________________________________________________________________________
InstitutionAddress:__________________________________________________________________________________________________
___________________________________________________________________________________________________________________
MobileNo:_________________________________________EmailAddress:_________________________________________________
Howdidyoulearnaboutthisconvention?(Plscheckallthatapplies)___Flier,___Poster,___Email,___ADNEPwebsite,___Text,
___Colleague,___Newspaper,___Other_____________________
Whatmotivatedyoutoattendthisconvention?(Plsrankaccordingtopriority1st,2nd,3rd,etc)
___ConventionTopics,___ExpertiseofSpeakers,___Venue,___ReasonablePrice,___CPEUnits,___Other_________________

Pleasefillintheremainingpaymentdetailsbeforesendingthisthroughfax:
Branchofpayment:_______________________________ DateofTransaction:________________________
TimeofTransaction:_______________________________ Amount:_________________________________

Contacts

0922.887.51.66
0907.290.25.75
0922.887.51.64
0999.517.74.66
0922.360.06.18
0916.602.23.35
0922.869.04.85
0917.446.87.93

Office Address:
Yancy T Camba
Menchie C Mangalino

Telefax: (02) 942.03.13


Website: www.adnep.org
Ma. Theresa E. Panelo, RND
Leyden V Florido, RN, MAN

94 new 571 old Apitong Street


Marikina Heights, Marikina City
***********************************


and

8th Joint
Association of

City of Manila
Levels Up
Diabetes Nurse

invite you to the


Educators of the

Century Park Hotel


Annual Convention
Philippines, Inc (ADNEP)

August 27 and 28, 2010,


Philippine Association of

Diabetes Education
Diabetes Educators, Inc (PADE)
Date and Time
Welcome August 27 and 28, 2010,
Friday and Saturday
Please fax or email validated deposit slip
with the registration form immediately to:
8:00 am 5:00 pm
Objectives Attention: PADE
Venue Telefax: (02) 942-03-13 or (02) 470-89-42
At the end of the 2 days convention, Century Park Hotel or (02) 869-04-78
the participants will be able to: City of Manila Email: convention@adnep.org
1) Boost Diabetes Education practice.
2) Reinforce partnership and communication Fee
among the members of the diabetes healthcare
team. Schedule of Members* Non-
3) Augment knowledge on the new Fees members II. Cash
developments related to the Diabetes Mellitus 1) Ma. Theresa E. Panelo, RND
Before Aug 13 2,500 3,000
disease process and management. c/o CDC @ Med Central,
After Aug 13 3,500 4,000
Ground Floor, Robinsons Galleria
Topics *Waived Membership Fee for 2010 - Entitled members are those who Ortigas, Mandaluyong City
updated their membership last August 2009 PADE/ADNEP convention,
ADNEP General Assembly 2010 and graduates of Diabetes Education
1. Latest Trends in Diagnosis and Management Training (Batches of October 2009, Summer 2010 [Iloilo and Marikina], 2) Maria Bernadette G. Platon, RND
of DM & LRI Lay Educators). c/o UST Hospital Dietary
2. Perspectives in Diabetes Education Espaa, Manila City
3. Find meaning in numbers: Interpret CBG Membership Dues
results in self-management of diabetes Regular Member 300.00 3) Maria Luisa H. Lopez, RN, RM, MAN
4. Avoiding Errors Associated with Insulin General Member 500.00 College of Nursing
Therapy Pamantasan ng Lungsod ng Pasig
5. A Review on Molecular and Metabolic The registration fee includes 2 snacks and 1
Dysfunction in Diabetes lunch for 2 days, and Certificate with CPE
units. Kits and souvenir programs are only CANCELLATIONS
6. Filipino Food Items
available for pre-registrants plus exciting prizes A 50% refund will be made for
7. Opportunities for Diabetes Education: registration cancellations received
A Panel Discussion await them. before August 16, 2010. No refunds
8. Linking To Create Impact At The Grass- can be made thereafter.
roots Level
9. Hypertension and Dyslipidemia Fees may be paid:
10. eLearning I. Bank Deposit You may also register through our website at
11. Facilitating Skills Development www.adnep.org
12. Poise and Looking Good Account name:
Philippine Association of Diabetes Educators Dress code:
Participants Account No.: 5951-0656-78 Business/ Smart Casual Attire
Physicians Bank: BPI Family Savings Bank
Nurses .
Nutritionist-Dietitians For check payments, please make check pay- Thank you and see you on
Students able to Philippine Association of Diabetes August 2010!
Interested Health Professionals Educators. Personal checks are not accepted.

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