COLUMNA ENERGY CONSULTING

Nuclear, Oil, Gas, Coal, Water, Renewables, Energy Efficiency, LEED

Block 17, Lot 3, Pulangi St., Riverview Place, Brgy. De Las Alas, GMA, Cavite 4117,
Philippines. Mobile Phone: 0926-809-3337. E-mail: Lope.Columna@yahoo.com

COMPANY REGISTRATION FORM

Contact
Company Name: _________________________________________ Person: ______________________________
Address: ____________________________________________________________________________________
Tels: ______________________ Mobile: _____________________ E-mail ______________________________

PARTICIPANT NAME

POSITION

COURSE TITLE

DATE

1. ___________________________ ____________________ ________________________ _____________

2. ___________________________ ____________________ ________________________ _____________
3. ___________________________ ____________________ ________________________ _____________
Company Business: ___________________________________________________________________________
Comments: __________________________________________________________________________________
PERSON AUTHORIZING REGISTRATION: ________________________________________________________
Position: _________________________________________ Signature___________________________________
SEMINAR FEE covers all course materials, refreshments during breaks and lunch, but excludes accommodation.
MODE OF PAYMENT (Please Check):
__ Cheque (payable to: COLUMNA ENERGY CONSULTING)
__ Bank Deposit __ Electronic Transfer
Account Name: LOPE COLUMNA
Account Number: 130-401-6244
Bank Name: RCBC (Rizal Commercial Banking Corporation)
Clark 2 Branch, Berthaphil III, Clark Center
Pampanga, PHILIPPINES
Swift Number: RCBCPHMM
Telex Code: 63547 RCBC, MKPN 22207
Full payment of the seminar fee is due upon filling up and submission of this reservation/registration form to
COLUMNA ENERGY and the listed participant/s are considered reserved in the course. Please note that full
payment must be received prior to the start of the training-seminar. If the payment is deposited in our Bank
Account, please e-mail the scanned Deposit Slip to us before the start of the seminar. Only delegates who have
made full payment will be admitted into the seminar unless agreed otherwise with COLUMNA ENERGY. In case of
the reserved participant not able to attend for any reason, a substitute participant is accepted, or the reserved
participant may attend other courses, or similar courses scheduled in the future.
COLUMNA ENERGY reserves the right to cancel or reschedule any course, at any time, before the start of the
seminar for reason/s beyond our control. For confirmation of the Schedule(s), please contact Engr. Lope
Columna: 0926-809-3337. E-mail: Lope.Columna@yahoo.com