INFORMATION SHEET FOR THE 2016 CONFERENCE

Name you want to be printed on your badge and directory
☐Mr. ☐Ms. ☐Dr. ☐Prof. / First name: / Last Name:
Institutional affiliation/s:
Would you like to include your email address in the directory?
☐ Yes
☐ No
Are you attending the optional tour on 6 October?
☐Yes
☐No
Please indicate if you have dietary requirements or special assistance needed during the conference
What is the best way for us to get in touch with you?
☐Email / Email address:
☐Landline / Landline number:
☐Phone / Mobile phone number:

Registration fee of PhP3,000 may be paid at the registration desk at the conference or through bank payments to: Philippine Sociological Society, BPI Loyola Branch. Account number 3081084032 (current account). Please enclose a scanned copy of the deposit slip to this form and email to:

The organizing team may be contacted via .

MEMBERSHIP FORM

MEMBER INFORMATION
Name:
Institutional Affiliation:
Position:
Mailing address:
Landline Number: / Mobile Phone Number:
Primary email address: / Secondary email address:
EDUCATIONAL BACKGROUND
Degree / Major / Institution / Year
RESEARCH INFORMATION
Research interests:
Membership in other professional associations:
MEMBERSHIP CATEGORY
Please tick the membership category applicable to you:
☐One year membership for undergraduate students (PhP 600)
☐One year membership for regular members (PhP 1,000)*
☐Three year membership for regular members (PhP 2,700)*
*With complimentary copy of Philippine Sociological Review per year
Signature: / Date:

Membership fees may be paid at the registration desk during the conference or through bank payments to: Philippine Sociological Society, BPI Loyola Branch. Account number 3081084032 (current account). Please enclose a scanned copy of the deposit slip to this form and email to:

PHILIPPINE SOCIAL SCIENCE CENTRE, COMMONWEALTH AVENUE, DILIMAN, QUEZON CITY, PHILIPPINES

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