60th PPS Annual Convention Registration 60th PPS Annual Convention Registration "*" indicates required fields Step 1 of 3 33% Choice of Convention Format* Face to face Virtual Type of Delegate*Convention AttendeeOrganizing Committee MemberBoard of TrusteePast National PresidentChapter PresidentPast Chapter PresidentSubspecialty Society PresidentSpeakerPPS Status* Member Non Member Residents/Fellows-in-training Government Physicians Allied Health Professionals Foreign Delegates (PPS Member) Foreign Delegates (Non Member) PPS Membership Status* Emeritus Fellow Fellow Diplomate Contact DetailsName*(as it appears on your PRC Card) First Middle Last PRC Number* Put N/A if foreign delegatePRC Expiry Date* MM slash DD slash YYYY Birth Date* MM slash DD slash YYYY PMA Number Phone Number*Email* Enter Email Confirm Email Chapter*National Capital RegionNortheastern Luzon ChapterNorthern Luzon ChapterCentral Luzon ChapterSouthern Tagalog ChapterBicol ChapterCentral Visayas ChapterEastern Visayas ChapterNegros Occidental ChapterWestern Visayas ChapterDavao/Southern Mindanao ChapterNorth Central Mindanao ChapterSouthwestern Mindanao Chapter Transaction DetailsAnnual Dues 2023 Price: Convention Fee Price: Convention Fee Price: Convention Fee Price: Total As Organizing Committee Member, you are exempted for the convention registration, kindly click the submit button. As VIP, you are exempted for the payment, kindly click the submit button. As Speaker, you are exempted for the registration fee. As Fellow in good standing, You are exempted for the annual dues. Foreign Delegate Fee (Non-Member) $200.00 Participant Early Registration Regular Member P4,000 P5,000 Non-Member P5,000 P6,000 Resident / Fellows in Training P3,000 P4,000 Government & Allied Health P3,000 P4,000 Foreign Delegates PPS Members P4,000 P5,000 Foreign Delegates Non-Members $200.00 $300.00 Pre-Convention P1,000 P1,500 Please coordinate to PPS Accounting if you have arrears. Payment Option*Please choose your payment optionAlready paid at PPS OfficeBank Transfer or Bank DepositConvention Transaction Number* Amount Paid* Convention Transaction Date* MM slash DD slash YYYY Annual Dues Transaction Number* Amount Paid* Annual Dues Transaction Date* MM slash DD slash YYYY Proof of payment*Attach your official receipt or deposit slip Drop files here or Select files Accepted file types: jpg, png, pdf, Max. file size: 5 MB, Max. files: 3. HiddenPAYMENT VERIFICATIONFor Internal Use OnlyFor VerificationPaid and Confirmed – F2FPaid and Confirmed – VirtualHiddenVERIFIED BYPayment is verified by? HiddenDATE VERIFIEDWhen was the payment verified? MM slash DD slash YYYY PhoneThis field is for validation purposes and should be left unchanged. Δ
