Registration Form

INTEGRATED BAR OF THE PHILIPPINES

9th Eastern Visayas Regional Convention

Bohol Tropics Resort Club, Tagbilaran City

March 11-13, 2010

REGISTRATION FORM


NAME:  ……………………………………………………………………………………………………………………………………………………………………
Last Name         First Name       Middle Name
CHAPTER: ………………… Attorney’s Roll No………… Life Membership No. ……………………………
ADDRESS: (Home)……………………………………………………… Tel No………………………………
( Office) …………………………………………………… Tel No………………
E-mail Address………………………………………… Mobile No……………………………
IBP POSITION:…………………………………………………………………………………………………………………………
Contact person in case of Emergency………………………………………Contact No…………………………………
Will be staying at ______________________________________________________
Interested to tour the Province
Through Travel Agency:     	Yes________		No___________
__________________________________
Registrant’s Name