Clone of 3rd PPAIFI SHARP

3rd PPAIFI SHARP

Course on Liposuction
Registrant Information
Full Name

First NameMiddle NameLast Name
Email Address
example@example.com
Mobile Number
Please enter a valid phone number.Format: (000) 000-0000.
Society
PMA Number
PRC Number
Picture of PRC ID

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Category and Proof of Payment
Category
prevnext( X )
Assist
1st assist

30,000.00 PHP

Observer
Observer

10,000.00 PHP

Total

0.00 PHP
Please Deposit Payment at PS Bank

Pan Pacific Aesthetic Institute Foundation Inc.

152-332000474
Proof of Payment

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EVENT PRIVACY POLICY
This is to certify that I hereby willingly and voluntarily consent that my personal information or data be used as a file for PPAIFI and shall be provided by PPAIFI to our partner Pharmaceutical and Non-Pharmaceutical Companies, consisting of the following:
* My Name
* My Clinic Address
* My Contact Number
* My Email Address
* My PRC Number

This is subject, however, to the condition that the said Pharmaceutical Company shall sign a Non-Disclosure Agreement with PPAIFI on our behalf as set forth by the Data Privacy Law and its IRR.
Registrant Signature
Should be Empty:

3rd PPAIFI SHARP