DELEGATES’ PRE-REGISTRATION FORM 3rd Cebu Energy Efficiency Forum 2013 One-Day Forum & Exhibition 16 July 2013, Tuesday 8:00AM to 6:00PM Radisson Blu Hotel, Cebu (Please fax completed form to 032 2533387) Company Name:____________________________________________________________________ Complete Address:__________________________________________________________________ Company TIN: _____________________________________________________________________ Contact Person:____________________________________________________________________ Telephone no:___________________________ Fax no: ____________________________________ E-mail:________________________________________ This is to confirm attendance of the following participants: I. ATTENDEES: Name Designation Email Address
Breakout Session to Attend (indicate group 1 or 2)
II. REGISTRATION FEE Delegate Rate: Php 2,500 20% Off Early Bird Discount (for payments MADE IN FULL on or before Friday, June 28, 2013) 5+1 Group Discount (must be submitted on or before Friday, July 12, 2013) The registration fee includes participation in all plenary sessions, morning & afternoon snacks, lunch and conference kit. III. PAYMENT: (Please choose your preferred payment option) Check for pick-up Direct Payment to ECCP office Date & Time of pick-up:__________________ Send to: ECCP Office, 3L CL Center, 14 J. Osmena St. cor Contact Person:________________________ Llorente St., Cebu City Check for Deposit (Please fax the deposit slip to 032 2533387 if payment has been made) ECCP Account Details (HSBC): Account Name: ECCP NOTE: Pre-Registration is REQUIRED. Cancellation or Request for refund will be accepted if notification is given in writing at least 3 Account #: 010-000842-040 working days prior the event, otherwise, full participation fees will be charged.