WaterLinks 2014 Forum

11-13August 2014, Manila, Philippines

REGISTRATION FORM

Please contact Elaine Garcia-Gatchalian, Zai Tan-Perez or Jeanne Dela Cruz for inquiries and for submissionat phone no. (63 2) 7235017/4007955, fax no. (63 2)7226462 and email add .

Submit one form per delegate

Top of Form

DELEGATE INFORMATION
Family Name: / Dr/ Prof/ Mr/ Ms/ Mdm
Given Name: / Gender: / Male / Female
Organization:
Mailing Address:
City: / State:
Post/ Zip Code: / Country:
Designation:
Tel No: / Fax No:
Email:
Special Dietary Requirement (if applicable)
Room preference / Single ____ Double____
Hotel Check In Date: / Hotel Check Out Date:

Bottom of Form

REGISTRATION
Conference fees include the entrance to the technical sessions, coffee breaks, lunches during the conference as well as the welcome dinner / cocktails / ON-SITE VISIT(Please tick ‘√’ only one) - 13 August 2014
□Foreign Delegates Early Bird Fee = USD150
□Local Delegates Early Bird Fee = PhP5,000.00
□Foreign Delegates Regular Fee = USD180
□Local Delegates Regular Fee = PhP6,000.00
*Early bird rate is until May 31, 2014 / □Maynilad Water Services on Non Revenue Water Management
□Manila Water on Septage Management
Limited slots available. Only 50 participants per site will be accommodated
Account details for payment through bank transfer:
Account Name: WaterLinks Management Council, Inc.
Bank: Banco de Oro
Branch/Address: Emerald Avenue Branch
G/F Unit 101 Taipan Place, Don Francisco Ortigas Jr Road,
Pasig City, Philippines
Saving Account No. : 101340167199
SWIFT CODE: BNORPHMM
PRIVACY
As a result of your participation in the WaterLinks2014 Forum, we will have your name and contact details on our database. We would like to send you information on future related conferences and exhibitions. However, we respect your privacy and will remove your details from our records if you wish.
Please tick this box if you do not wish to receive any information.
______
Name/ Signature / ______
Date