Mechanika 2007

download here! The Printable Registration Form

Registration Form

Name:

Designation:

Company:
Address:

Tel.No(s):		Fax:
Email:		Website:

1. PSME Member? no yes, chapter

2. Life Member? no yes, #

3. PRC License RME# PME#

4. Industry (please check applicable)

5. I am interested to join the following:

6. I will be a delegate to the 55th Annual National Convention. Below are my payment details:

Registration Fee

P 4,100.00

Life Membership Discount

3,690.00

Early Bird Discount

3,690.00

(Full Payment on or before October 01, 2007)

TOTAL APPLICABLE PAYMENT........

MODE OF PAYMENT:		I will bring to PSME Office
		Request for pick-up
		Direct Deposit to PSME Account - PS Bank Account Name: Philippine Society of Mechanical Engineers Account Number: Please fax deposit slip to (632)869-7309 Attention: Engr. Celestino Canaca Jr.

Date: