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2019 Convention - Confirmation Form
2019 Convention - Confirmation Form
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REGISTRATION / CONFIRMATION FORM
If unable to Register ONLINE, Please email or Fax this form to (02) 412-2033
I / We hereby confirm my / our participation in the AGIA 2019 Annual National Convention Cum Seminar to be held on
October 8-11, 2019 at the Waterfront Hotel, Salinas Drive, Lahug, Cebu City
Agency Category:
NAME OF AGENCY / OFFICE: ____________________________________________________ [ ] GOCC / GFI [ ] NGA
Address: ______________________________________________________________________ [ ] LGU [ ] SUC
PRIVACY NOTICE:
We will use this information to register you in our training/membership events and photos/videos as this will be taken as evidentiary purposes in relation
to AGIA events. We will use this information to provide services regarding your attendance. By giving your personal information, you consent to our use
of it for the purposes described in this Privacy Notice.
Note: Please PRINT legibly for Certificate purposes. Use additional sheets if necessary.
APPROVED BY:
________________________________________________________
Name & Signature of Head of Agency/Office OR Authorized Officer
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