#idpac19 Registration Form

** ONLINE REGISTRATION is now closed.

Please be advised that we will be accepting ONSITE REGISTRATION at the PICC beginning December 9, 2019.

Please note that ONSITE REGISTRANTS are not eligible to join the Pre-Congress Workshops.

All ONSITE transactions shall be paid on a strict CASH basis. For international delegates, registration fees shall be paid onsite in PHILIPPINES PESOS (PHP); please visit our website or see the table below to view USD-to-PHP conversions.

If you are a CONGRESS SPEAKER or have been provided a PROMOTIONAL CODE, please enter it below to complete your registration.

Please select if you are registering as a *

Philippine Delegate/ Citizen International Delegate

Please visit our website at https://manilaidpacongress.org/registration-local-instructions/ to read the full registration procedure and list of Congress fees.

A picture or scan of your validated deposit slip is required to complete this registration.

Name as it will appear in your Certificate of Attendance *

First Name Middle Initial Last Name Suffix

Email Address *

Please make sure to provide a valid email address as your confirmation details will be sent here. This will be required to claim your registration kit.

Mailing Address *

Street Address
Street Address Line 2
City	State/Province
Zip Code	Country

Which Region of the Philippines do you belong to? *

Country of Residence *

Country of Residence

Please be informed that the PayPal gateway is not available in your country. May we please request you to follow this guide to walk you through the registration process.

STEP 1	Please send an email to the Registration Committee at registration@manilaidpacongress.org and indicate your intent to attend the Congress. Please include your full name and email address, as well as a scanned copy of your passport for verification purposes.
STEP 2	A special code shall be then emailed to you that will allow you to complete your online registration.
STEP 3	Once said email is received, please register online and follow the instructions therein.
STEP 4	Upon completion of the form, kindly wait for an ACKNOWLEDGEMENT EMAIL that we have received your registration form. Please check your submitted details for any errors.
STEP 5	We will also send you a CONFIRMATION EMAIL that you have successfully registered for the Congress.
STEP 6	PRINT out your confirmation letter and bring this letter together with your payment when you register to claim your Congress Kit.
STEP 7	Your registration fee of USD {calculation} will be collected when you arrive to claim your Congress Kit. Please note that only CASH Payments in Philippine Pesos will be accepted. Credit card payments will NOT be available onsite. You are encouraged to exchange your currency to Philippine Pesos at the airport before proceeding to your hotel.

For international delegates, please visit https://consular.dfa.gov.ph/visainformation for a list of visa requirements prior to your visit to the Philippines.

For any additional concerns, please contact registration@manilaidpacongress.org.

Do you require a VISA to enter the Philippines?

Yes No

Visa Document Number (if applicable)

Please type in your Philippine Visa Document Number here.

Contact Number *

Area Code Phone Number

Contact Number *

Country Code Area Code Phone Number

Profession

Please indicate your profession.

PRC ID Number (if applicable)

Please indicate your PRC ID Number (if applicable)

IDPA Member ID Number (if applicable)

Please indicate your IDPA Member ID Number (if applicable)

Name of Organization

Name of Organization (if applicable)

Institution/ Hospital/ Center Affiliation

Name of Insitution/ Hospital/ Center (if applicable)

Please select a Pre-Congress Workshop you are most interested in. (and two alternates)

Please select the Pre-Congress Workshop you are most interested in. *

Pre-Congress Workshop Preference

Please indicate the first of two alternates should your primary choice be unavailable

Pre-Congress Workshop Alternate

Please indicate the second of two alternates should your primary choice be unavailable

Pre-Congress Workshop Alternate

Meal Preference *

No Restrictions Vegetarian Halal

Would you be interested in attending the Mentoring Dinner?

Yes No

Did you submit an abstract?

Yes No

Do you have a promotional code?

Yes No

Please enter your promotional code here

Calculation

Registration Fee (via PayPal)

USD Your registration fee has been calculated according to your present Country of Residence, as well as its corresponding World Bank Economy Ranking (2018).

Please indicate the name to be placed on the Official Receipt

Validated Bank Deposit Slip Upload *

Browse Files

Please attach a jpeg or pdf file of your validated deposit slip.

Valid Photocopy or Scan of Passport/ Identifying Document *

Browse Files

Please attach a jpeg or pdf file of your Passport or Identifying Document

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