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Biotech Solutions for Health

Online Registration Form

First Name:

Middle Initial:

Last Name:

Title:

Nickname
for
Name Tag:

Affiliation:

Mailing Address:

E-mail:

Tel No.:

Telefax No.:

I would like to:

Attend the 33rd PSBMB Annual Convention
Attend the 6th RevUp Workshop
Registration Fee fot 6th RevUp: FREE

Presentation
Preferred:

Oral Presentation
Poster Presentation
Young Scientists’ Forum Presentation

Title of Paper:

Registration Fee:	Early Bird (by 31 Oct. 2006)	Regular (31 Oct. 2006)
Members	PHP 1,500	PHP 1,800
Non-members	PHP 2,000	PHP 2,500
Students*	PHP 800	PHP 1,200
One day only (excluding fellowship night)		PHP 1,500 Date Preferred:

* Students must present valid ID or other proof of school registration.

Payment Method:

Direct deposit to BPI Account of PSBMB:
Cash
Check - Bank
                     - Check No.

Check to secretariat:
Check - Bank
                     - Check No.

Money Order
Bank Transfer

Dietary Restrictions:

Payment should be done in cash or by check addressed to PSBMB through the secretariat or via the Bank of the Philippine Islands (Account No. 3080-0037-48, BPI Loyola-Katipunan Branch, Quezon City). All early bird registrants must submit the completed registration form and a copy of the deposit slip to the Secretariat on or before 31 October 2006. Fax or electronic copies are acceptable for pre-registration, but the original deposit slip should be submitted at the registration desk on the day of the convention.

The PSBMB has been a member of the Federation of Asian and Oceanian Biochemists and Molecular Biologists (FAOBMB; formerly FAOB) since 1973, it also represents the Philippines in the International Union of Biochemistry and Molecular Biology (IUBMB; formerly IUB).