ONLINE REGISTRATION FOR 9TH GENERAL ASSEMBLY (Group Registration)
Personal Details
Name of Delegate * Required
Total Delegates * Required	23456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100
Position
Organization
Province/Municipality/City
Mailing Address
Telephone Number
Fax Number
Mobile Number * Required
E-mail Address * Required	ex. xxxx@yyyy.com
Remarks (Names of other delegates if registering as group, separated by coma) * Required
Payment Details
Registration Fee	4,200.00 / Person
Optional Tour	1,300.00 / Person
Tour packages taken * Required	01234567891011121314151617181920
Total amount paid * Required
Paid through Metrobank Branch * Required
Date deposited payment * Required	12345678910111213141516171819202122232425262728293031 January February March April May June July August September October November December 20102011201220132014201520162017201820192020

* Required field

In order to process your registration, we hope to receive your registration fee to the assembly through:

Bank                            : METROBANK-QUEZON CITY ROTONDA BRANCH
Account name             : Philippine Federation of Local Councils of Women (PFLCW) Inc.
Account number         : CA NO. 7-177-52405-7