REGISTRATION

Name *

Company/Organization *

Phone *

Email Address *

How many ACTIVE PSEM Members? *

How many INACTIVE PSEM Members? *

How many PSEM NON-MEMBERS ? *

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ACTIVE PSEM MEMBER

Proceed next if none.

ACTIVE PSEM MEMBER REGISTRATION FIELD

PLEASE INDICATE CHAPTER *PLEASE INDICATE CHAPTER

BICOL CHAPTER ( ACTIVE MEMBER ) *SEARCH NAME

CARAGA CHAPTER ( ACTIVE MEMBERS ) *SEARCH NAME

CENTRAL LUZON CHAPTER ( ACTIVE MEMBERS ) *SEARCH NAME

LEPANTO CHAPTER ( ACTIVE MEMBERS ) *SEARCH NAME

MAEM ( ACTIVE MEMBERS ) *SEARCH NAME

NCR CHAPTER ( ACTIVE MEMBERS ) *SEARCH NAME

NLC ( ACTIVE MEMBERS ) *SEARCH NAME

NMB CHAPTER ( ACTIVE MEMBERS ) *SEARCH NAME

PALAWAN CHAPTER ( ACTIVE MEMBERS ) *SEARCH NAME

PHILEX MINING CORPORATION *SEARCH NAME

VISAYAS CHAPTER ( ACTIVE MEMBERS ) *SEARCH NAME

UPLOAD PRC ID ( FRONT ) *

No file chosen

UPLOAD PRC ID ( BACK ) *

No file chosen

Are you an Accredited Competent Person? *YesNo

ACP No.

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INACTIVE PSEM MEMBER

Proceed next if none.

INACTIVE PSEM MEMBER REGISTRATION FIELD

PLEASE INDICATE CHAPTER *PLEASE INDICATE CHAPTER

BICOL CHAPTER ( INACTIVE MEMBERS ) *SEARCH NAME

CARAGA CHAPTER ( INACTIVE MEMEBRS ) *SEARCH NAME

CENTRAL LUZON CHAPTER ( INACTIVE MEMBERS ) *SEARCH NAME

LEPANTO CHAPTER ( INACTIVE MEMBERS ) *SEARCH NAME

MAEM ( INACTIVE MEMBERS ) *SEARCH NAME

NCR CHAPTER ( INACTIVE MEMBERS ) *SEARCH NAME

NLC ( INACTIVE MEMBERS ) *SEARCH NAME

NMB CHAPTER ( INACTIVE MEMBERS ) *SEARCH NAME

PALAWAN CHAPTER ( INACTIVE MEMBERS ) *SEARCH NAME

PHILEX MINING CORPORATION *SEARCH NAME

VISAYAS CHAPTER ( INACTIVE MEMBERS ) *SEARCH NAME

UPLOAD PRC ID ( FRONT ) *

No file chosen

UPLOAD PRC ID ( BACK ) *

No file chosen

Are you an Accredited Competent Person? *YesNo

ACP No.

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PSEM NON-MEMBER

Proceed next if none.

PSEM NON-MEMBER

Name *

Phone *

Email Address *

Profession

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ORDER OF BILLING:

TYPE	AMOUNT	NO. OF DELEGATES	TOTAL
ACTIVE PSEM MEMBER	4,000	{number-1}	{calculation-1}
INACTIVE PSEM MEMBER	6,000	{number-5}	{calculation-6}
PSEM NON-MEMBERS	6,000	{number-4}	{calculation-4}
		GRAND TOTAL	{calculation-5}

HOW TO PAY?

All delegates can pay through the following:

Bank Transfers / Online Banking
Gcash/Paymaya to CHINABANK

BANK DETAILS
Bank Name: CHINABANK ( CHINABANKING CORPORATION )
Account Name: Philippine Society of Mining Engineers Northern Luzon Chapter
Account Number: 1690541415

ACTIVE PSEM MEMBER RATES

INACTIVE PSEM MEMBER RATES

PSEM NON-MEMBERS

TOTAL PAYMENT TO BE PAID

UPLOAD PROOF OF PAYMENT *