PSCN 2026 Annual Meeting (Oct 10-11, 2026) Registration Form

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For best experience, fill up this form using a laptop or desktop. A mobile phone can also be used but the alignment/margins might vary per device.

For any questions or queries, please feel free to communicate with us via email (philneurophysio@gmail.com)
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Invoice ID
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Full Name:* This field is required.
First Name
Middle Name
Last Name
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Gender* This field is required.
Male
Female
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PRC Number:* This field is required.
If none, type N/A
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PRC Expiry Date
Leave blank if no PRC ID
Month
Day
Year
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Profession* This field is required.
Consultant Physician
Physician-In-Training (Resident)
Non-Physician
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Medical Specialty* This field is required.
Neurology
Neurosurgery
Rehabilitation Medicine
Orthopedic Surgery
Internal Medicine
Other
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Health Care Specialty* This field is required.
Neurophysiology Technician
Nurse
Physical Therapist
Occupational Therapist
Other
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Name of Hospital / Institution / Company / School Affiliation* This field is required.
If none, type N/A
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Address of Hospital / Institution / Company / School:* This field is required.
If none, type N/A
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Other Hospital/Institution/Company/School Affiliations and Address, if any
if none, type N/A
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Mobile Number:* This field is required.
Enter a valid mobile number
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Email Address:* This field is required.
Enter a valid email address
Confirm Email
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I am a PSCN MemberNot a member? visit www.philneurophysio.com to apply!
Yes
No
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PSCN ID:* This field is required.
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PSCN ANNUAL MEETING DELEGATE RATES FOR PHYSICIANS

EARLY BIRD REGISTRATION (until September 30)
P5,000.00
Plenary + Workshop
P4,000.00 (for PSCN members only)

Includes:
Complete Access to Scientific Meeting / Plenary Proper
Complete Access to EMG-NCV Workshop Proper
Scientific Meeting Souvenir Kit

P3,000.00 - BASIC WORKSHOP ONLY
P5,000.00 - ADVANCED WORKSHOP ONLY

CLICK NEXT FOR PAYMENT DETAILS
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PSCN ANNUAL MEETING DELEGATE RATES FOR NON-PHYSICIANS
AND/OR RESIDENTS-IN-TRAINING

EARLY BIRD REGISTRATION (until September 30)
P5,000.00
Plenary + Workshop
P4,000 (for PSCN members only)

Includes:
Complete Access to Scientific Meeting / Plenary Proper
Complete Access to EMG-NCV Workshop Proper
Scientific Meeting Souvenir Kit

P3,000.00 - BASIC WORKSHOP ONLY
P5,000.00 - ADVANCED WORKSHOP ONLY

CLICK NEXT FOR PAYMENT DETAILS
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PAYMENT FOR PSCN 2026 ANNUAL MEETING

You may submit payment
(via online transaction or bank deposit, or GCASH)

PHILIPPINE SOCIETY OF CLINICAL NEUROPHYSIOLOGY, INC.
BDO St Lukes BGC Branch
Acct No 0070 - 1801 - 0641

GCASH
Evelyn Chua-Ley
Treasurer, Philippine Society of Clinical Neurophysiology
(0932) 257 5261

To help us confirm your registration, please attach a screenshot/image of your proof of payment on next page, or alternatively you can email it to: philneurophysio@gmail.com

Please also indicate your name during the transfer (add notes to online payment)
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PROOF OF PAYMENT: Please upload a screenshot (in JPG/PNG/PDF format) of your proof of payment (screenshot of online transaction or picture of bank deposit slip) by clicking on the box below:Alternatively, you may email to philneurophysio@gmail.com (but proof of payment needed to process your registration)
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PAYMENT NOTES
Please type in any important notes related to your payment details (ex. need OR, address to company, etc). May leave blank if none
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Headcount Survey: I Will ATTEND the Workshop ProperThis is to help us distribute the attendees to the different available machines
Yes
No
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Headcount Survey: I Will NEED AccommodationsSPECIAL RATES are available for delegates, which will be coursed thru your email
Yes
No
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Headcount Survey: I Will ATTEND the Fellowship NightThis is to help us secure enough seats for the event nightcap
Yes
No
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An acknowledgement email will be provided once your information has been processed by the society. If you wish to receive an official receipt, please indicate details in the payment notes on the previous page.

PLEASE REVIEW YOUR INFORMATION CAREFULLY

If everything is correct and complete, click the SUBMIT below to finalize your registration.
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