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26th Philippine Institute of Certified Public Accountants (PICPA) Mindanao Geographical Area Conference

and
th
37 Association of Certified Public Accountants in Mindanao (ACPAMIN) Conference
AUGUST 24-25, 2018
ASTORIA REGENCY CONVENTION CENTER, PASONANCA ROAD, ZAMBOANGA CITY

Hosted by: Philippine Institute of Certified Public Accountants


Zamboanga-Basilan Chapter

REGISTRATION FORM
Last Name First Name Middle Name Nickname Sex CPA No.

Business, Company / Institution Affilated With Address

Title / Position Telephone / Cellphone No. Email Address

PICPA Member Sector Region Chapter

Yes No

REGISTRATION FEES (Inclusive of 12% VAT) REMITTANCE

Registration will be valid only upon receipt of fully completed form and
Before June 30 P 4,000 payment of the registration form.
Before July 31 P 4,500
July 31 Onwards and Walk-Ins P 5,000 Cash

REGISTRATION FEES ARE NON-REFUNDABLE. Check


Bank Name
Check No.
Note: Please ensure that this form is clearly and completely filled up. Date of Check

Please email or fax the completed form to: Others

Fax Numbers: (062) 984-2207 / 991-1011 Payee should be: PICPA ZAMBAS CHAPTER
Email Address: acpamin2018@gmail.com
Deposit online to: PICPA ZAMBAS CHAPTER
For inquiries, please contact the CONFERENCE SECRETARIAT: Land Bank of the Philippines
Account Number: 0191 3258 00
Conference Chair Elizabeth Parreño
0917-521-7033 Note: Please fax or email your validated deposit slip with your name
and CPA No. to the Conference Secretariat.
Chapter President, FY 2018-2019 Brenda Luz Molina
0915-531-5304

Chapter Secretary, FY 2018-2019 Florivel De Jesus


0917-724-5918