39th PNA Annual Convention and 12th ASNA Biennial Convention
REGISTRATION
Local Delegate
Foreign Delegate
Title
First Name
Last Name
Suffix
Designation
E-mail
Mailing Address
Tel. No.
Fax No.


Registration Rates

 
Delegate
Early Bird
On or before Sept. 30, 2017
Onsite
Oct. 1, 2017
Consultant $250 $300
Resident $100 $150
PNA Founding Member $0 $0
PNA Past President $0 $0
ASNA Executive Committee $0 $0
ASNA 2017 Organizing Committee $0 $0
Speaker $0 $0

1 Proof of status is required

Pay this amount:
$0

 

 

 

Payment Options:

 CREDIT CARD

 BANK PAYMENT DETAILS

Account Name :PHILIPPINE NEUROLOGICAL ASSOCIATION
Peso Account No. :3891-0217-54
USD Account No. :3894-0051-48
Bank Name :Bank of the Philippine Islands
Bank Address : St. Luke’s Medical Center Branch
E. Rodriguez Ave., Quezon City
Telno. :(+632)722-9791
Swift code :BOPIPHMM

To ensure confirmation of your registration:

  1. Please e mail a scanned copy of your deposit slip as proof of payment to philneuro@gmail.com.

  2. Please advise your bank to use the MT103 form when sending your payment.