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8th March, 2013 TO: Hospital Director / Nursing Director / Dean / Operating Room - Delivery Room Manager / Perioperative

Nurse / Doctor / Support Team / Professor / Student Dear Sir / Madam: Mabuhay!
The Operating Room Nurses Association of the Philippines, Inc. (ORNAP) will hold its 39 th Annual Convention and Scientific Meeting on July 5 to 7, 2013 at Manila Hotel, Fiesta Pavilion with the theme POWER OF CONVERGENCE IN PERIOPERATIVE NURSING. We have lined up strong and interesting topics for the convention, with the aim of bringing together perioperative participants from different cities and provinces to have exchange of ideas, education and professional development. With these, we invited several renowned speakers to share their expertise on the current and future trends in the advancement of perioperative nursing practices, ethico-legal issues, surgery, anesthesia, leadership, management, as well as other issues vital in nursing practice. In such, we would like to seek your support by joining us in this significant event.

Thank you very much and God Bless. Sincerely yours, Sgd. ELESA B. MANAHAN, RN Vice-President Over-All Chair, 39th Annual Convention and Scientific Meeting Noted by: Sgd. ANALYN H. SALIVIO, RN, MAN President
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Important Reminder: Fill up this form completely. Use communication below to send back to ORNAP.

CONVENTION REGISTRATION FORM

Email Address: mailornap@yahoo.com Website: www.ornap.org Mobile Phone: 0918 -4656271 Bank: Metrobank, United Nation Avenue, Ermita, Manila Account number: 044 7000 945 443 Paid to: ORNAP, Inc. Mailing Address: Unit 915 Le Gran Eisenhower Street, San Juan, Metro Manila 1. CONTACT INFORMATION: Name: RN License#:_________ ORNAP Membership I.D # :_______ New:____ Reg:___ Lifetime___ Title: _________________________________________________________________________ Email: ________________________________________________________________________ (required to receive registration confirmation) Facility/Workplace: ____________________________________________________________ Address: _____________________________________________________________________ City: ___________________________ Zip Code: _____________________________________ Home Address: _______________________________________________________________ City: ___________________________ Zip Code: _____________________________________ Mode of payment: . Cash Cheque Bank and Account #______________________ Amount in word: __________________________________________________ Php ________ 2. CREATE YOUR PROFILE 1. How many years have you attended ORNAP Convention?
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__1-3 years __4-7 years

__8-10 years __11 years and above

2. What best describe where you are employed? __Private __Government __Clinic __School __Vendor __Community Hospital __Manufacturer __Other 3. What represents your area of specialty? __OR __DR __E.R __Ward __Endoscopy __ICU __Coordinator __Educator/Staff Development __Others_____________________ 4. What represents your position? __Director __Dean __Manager __Professor __Staff Nurse __ Sales/Marketing Specialist __Others__________________________ REGISTRATION TERMS AND CONDITIONS CANCELLATIONS:
Cancellations must be made in writing. Cancellations made after May 31, 2013 will be subject to a cancellation fee of Php 1,000.00. Registrants who do not cancel prior to June 21, 2013 will be liable for full registration fee. Non-payment or non attendance does not constitute cancellation. If for any reason, ORNAP Committees and Board of Directors decide to cancel or postpone the convention, the latter is not responsible for covering airfare and other travel costs incurred by clients. Refunds due to registrant error will be charged a Php 500.00 processing fee. No refunds will be granted prior to the event or after July 7, 2013.

__Doctor __Consultant __Student __Technician

SUBSTITUTIONS: Substitutions may be made at any time for confirmed registrants. Notice of substitution MUST be made in writing and send thru email mailornap@yahoo.com or mail to: Operating Room Nurses Association of the Philippines, Inc. (ORNAP) Unit 915,Le Gran Condominium, Eisenhower Street, Greenhills, San Juan, Metro Manila

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Date: ___________________
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Signature of Participant

3. REGISTRATION CATEGORY: PRE-REGISTRATION: (Until June 15, 2013) Lifetime member / Senior Citizen Php 3,600.00 Regular Member Php 3,800.00 Non-member Php 4,000.00 ON SITE REGISTRATION: (June 16 to July 7, 2013) Lifetime member / Senior Citizen Php 3,800.00 Regular Member Php 4,000.00 Non-member Php 4,200.00 MEMBERSHIP: acceptance of membership for the next TERM of office Fiscal year will start on March 30, 2013
New member Renewal Lifetime membership Php 300.0 Php 300.00 Php 3,000.00

NOTE: Registration on convention and membership are all VAT inclusive. MEMBERSHIP application form to be download (lifetime, regular, new) at website www.ornap.org 4. HOTEL ACCOMMODATION:

ROOM TYPE Superior Deluxe Single/Twin


QUESTIONS:

SPECIAL RATE/NIGHT Special Rate: Php 6,500.00 Regular Rate: USD 350++ or Php 17,650.00

INCLUSIVE DATES July 5-7,2013 (pls. contact 0921-723-0902 to avail this Special Rate)

Please contact ANALYN H. SALIVIO, President, Manila Doctors Hospital 4

# 09217230902 ELESA B. MANAHAN, Vice-President St. Likes Medical Center #09228753952 EUGENE C. CAMELLO, Treasurer Veterans Medical Center # 09228918914 Email Address: mailornap@yahoo.com Website: www.ornap.org

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