incollaborationwith:

REGISTRATIONFORM

AwarenessSeminaronISO9001:2015BSEN15224QMSforHealthcareService

29October2018,Monday

NKTIAuditoriumNationalKidney&TransplantInstitute,EastAvenue,Diliman,QuezonCity

REGISTRATIONFEE(InclusiveofTrainingFee,Meal,MaterialsandCertificate)Government:P2,000+VAT| Private:P2,500+VAT

First-come-first-serve.Limitedseatsonly.Pleaseregisteronorbefore17October2018NameofDelegate:CompanyName:☐ Private☐GovernmentPosition:

Address:Tel.No.:FaxNo.:Mobile:Email:ForAdditionalDelegate/s(pleaseuseextrasheetifnecessary)

Name Title Email1. 2. 3. Pleasechooseoneonly(ü )AMSESSION(9amto1pm):¨ PMSESSION(2pmto6pm):¨ ContactPerson:

Signature:

HowtoRegister PaymentInstructions1. SendthisRegistrationFormthroughemail:

info@health-core.orgorFBMessenger:HealthCore2. AttachcopyofDepositSlipasproofofpayment.3. AconfirmationemailwillbesentbySecretariatthat

willserveasyourPass/IDtotheworkshop.

HealthCoreInternationalConsultancyInc.UnionBank-P.Tuazon,CubaoBranchPesoCurrentAccountNo.00204-000682-0