Circular2015 karl larson workshop reg form

Page 1

Individual Regular Participant per workshop

Special Partner Rate (15% discount)

Php 33,600.00 per participant Php 28,560.00 per participant Prices are inclusive of VAT, food (AM snacks, lunch and PM snacks) and workshop materials DELEGATE 1 DETAILS (All fields are required) Full Name:

(Last Name)

Designation:

(First Name) Department:

Nickname:

(Middle Initial)

Organization: Office Address: Telephone No.:

Mobile No.:

E-mail:

Dietary Requirements:  Driving Organization Transformation

Workshop/s Attending: Type of Attendee:

 Regular Participant

 Strategic HR Shift

 Sponsor Delegate

 Both Workshops

 Partner Delegate

DELEGATE 2 DETAILS (All fields are required) Full Name:

(Last Name)

Designation:

(First Name) Department:

Nickname:

(Middle Initial)

Organization: Office Address: Telephone No.:

Mobile No.:

E-mail:

Dietary Requirements:  Driving Organization Transformation

Workshop/s Attending: Type of Attendee:

 Regular Participant

 Strategic HR Shift

 Sponsor Delegate

 Both Workshops

 Partner Delegate

DELEGATE 3 DETAILS (All fields are required) Full Name:

Nickname: (Last Name)

Designation:

(First Name) Department:

(Middle Initial)

Organization: Office Address: Telephone No.:

Mobile No.:

E-mail:

Dietary Requirements:

Workshop/s Attending: Type of Attendee:

 Driving Organization Transformation  Regular Participant

 Strategic HR Shift

 Sponsor Delegate

 Both Workshops

 Partner Delegate

Suite M3 Seven East Building, #7 East Capitol Drive, Barangay Kapitolyo, Pasig City | T: (02) 661-5954 / 746-2961 | C: 0917-5124520


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