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111th & 112th Philippine Dental Association

May 11-14, 2021 at SMX Conventio

List for Unrefunded 111th Pre Registrants FOR


(For Unrefunded Members who paid fo

Date of Submission
CHAPTER
SINAGTALA PRESIDENT

No. Complete Name on PRC ID PRC No.


CHRISTIAN A. MASANGKAY 0048793
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*****. PLEASE ATTACHED PROOF/S OF PAYMENT BELOW
111th & 112th Philippine Dental Association Annual Convention
May 11-14, 2021 at SMX Convention Center

r Unrefunded 111th Pre Registrants FOR HYBRID CONVENTION


(For Unrefunded Members who paid for HYBRID)

Contact Number
Email Address

Chapter Email Address


ANTIPOLO CITY DENTAL CHAPTER 112pdaregcom@gmail.com
OF PAYMENT BELOW
ON

Contact No. PDA Membership Payment Receipt No.


9228414424 ₱1,000.00 0001
111th & 112
Ma

Remmittance Form

CHAPTER
SINAGTALA PRESIDENT

No. Complete Name on PRC ID PRC No.


CHRISTIAN A. MASANGKAY 0048793
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*****. PLEASE ATTACHED PROOF/S OF PAYMENT BELOW


111th & 112th Philippine Dental Association Annual Convention
May 11-14, 2021 at SMX Convention Center

Remmittance Form for 112th ANNUAL CONVENTION VIRTUAL

Contact Number
Email Address

Chapter Email Address


ANTIPOLO CITY DENTAL CHAPTER 112pdaregcom@gmail.com
OOF/S OF PAYMENT BELOW
on Annual Convention
ntion Center

ONVENTION VIRTUAL

Contact No. PDA Membership Payment Convention Payment


9228414424 ₱1,000.00 ₱2,000.00
Receipt No.
0001
111t

Remmittance

CHAPTER
SINAGTALA PRESIDENT

No. Complete Name on PRC ID PRC No.


CHRISTIAN A. MASANGKAY 0048793
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*****. PLEASE ATTACHED PROOF/S


111th & 112th Philippine Dental Association Annual Convention
May 11-14, 2021 at SMX Convention Center

Remmittance Form for 112th ANNUAL CONVENTION VIRTUAL

Contact Number
Email Address

Chapter Email Address


ANTIPOLO CITY DENTAL CHAPTER 112pdaregcom@gmail.com
LEASE ATTACHED PROOF/S OF PAYMENT BELOW
onvention

TION VIRTUAL

Contact No. PDA Membership Payment Convention Payment


9228414424 ₱1,000.00 ₱2,000.00
Receipt No.
0001
111th & 1

Remmittance Form

CHAPTER
SINAGTALA PRESIDENT

No. Complete Name on PRC ID PRC No.


CHRISTIAN A. MASANGKAY 0048793
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*****. PLEASE ATTACHED PROOF/S OF PAYMENT BELOW


111th & 112th Philippine Dental Association Annual Convention
May 11-14, 2021 at SMX Convention Center

Remmittance Form for 112th ANNUAL CONVENTION VIRTUAL

Chapter Email Address


ANTIPOLO CITY DENTAL CHAPTER 112pdaregcom@gmail.com
OF PAYMENT BELOW
ual Convention
Center

VENTION VIRTUAL

Contact No. PDA Membership Payment Convention Payment


9228414424 ₱1,000.00 ₱2,000.00
Receipt No.
0001

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