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    The Edukcircle: International Education Circle Iccs

    Uploaded by

    JOHN CARLOS GERALDINO
    The document is a registration form for programs offered by The EdukCircle International Education Circle ICCS. It includes fields to provide contact information such as name, address, university/company, date of birth, and emergency contact. It also lists the registration fees for different participant types and dates, including early bird, late, and member rates. Payment can be made via bank deposit to a specified BDO account. Upon completion, participants will receive an e-Certificate of Participation.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    The Edukcircle: International Education Circle Iccs

    Uploaded by

    JOHN CARLOS GERALDINO
    69 views2 pages
    The document is a registration form for programs offered by The EdukCircle International Education Circle ICCS. It includes fields to provide contact information such as name, address, university/company, date of birth, and emergency contact. It also lists the registration fees for different participant types and dates, including early bird, late, and member rates. Payment can be made via bank deposit to a specified BDO account. Upon completion, participants will receive an e-Certificate of Participation.

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    Registration Form

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    The document is a registration form for programs offered by The EdukCircle International Education Circle ICCS. It includes fields to provide contact information such as name, address, university/company, date of birth, and emergency contact. It also lists the registration fees for different participant types and dates, including early bird, late, and member rates. Payment can be made via bank deposit to a specified BDO account. Upon completion, participants will receive an e-Certificate of Participation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    69 views2 pages

    The Edukcircle: International Education Circle Iccs

    Uploaded by

    JOHN CARLOS GERALDINO
    The document is a registration form for programs offered by The EdukCircle International Education Circle ICCS. It includes fields to provide contact information such as name, address, university/company, date of birth, and emergency contact. It also lists the registration fees for different participant types and dates, including early bird, late, and member rates. Payment can be made via bank deposit to a specified BDO account. Upon completion, participants will receive an e-Certificate of Participation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    The EdukCircle

    International Education Circle ICCS


    ______________________________________________________________________________________________
    12L El Jardin Del Presidente Tower II, 38 Sgt. Esguerra Street, South Triangle, Quezon City, Philippines 1103
    Telefax # (632) 83669952 or (632) 83627918 Email: edukcircle@yahoo.com Website: www.edukcircle.com
    facebook.com/TheEdukCircle Instagram: @edukcircle, Twitter: @edukcircle

    REGISTRATION FORM

    Program: ___________________________

    ______________________________ ____________________________________________ ____________________________________________


    Surname First Name Middle Name

    __________________________________________________________________________________________________________
    Current Address

    ________________________________________________ ______________________________________ __________


    University/Company Course/Designation Year

    ____/____/_________ _____________________ ______ _________


    Birth date Birthplace Age Gender

    ___________________ ______________________ ________________________________________________


    Home Phone Mobile No. Email Address

    Emergency Contact: _____________________________________________________ __________________________


    Name (optional) Mobile No. (optional)

    Registration Fee (non-refundable)


    Students and Teachers

    __ Early Bird August 01 –September 30, 2021 __P650


    __ Late October 01 – 05, 2021 __P900
    __ Members August 01 – September 30, 2021 __P500

    Non-University Participants

    __ Early Bird August 01 – 31, 2021 __P1,000


    __ Regular September 01 – 30, 2021 __P1,500
    __ Late October 01 – 05, 2021 __P2,000

    BDO
    Account Name: International Education Circle ICCS Co. Account Number: 001620183895

    Inclusive of:
    Authenticated e-Certificate of Participation

    ------------------------------------------------------------------------------------------------------------------------------------------------

    I hereby certify that the above details are true and correct.

    ______________________________ ___/___/______
    signature over printed name Date

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