Local Delegates SINAG REGISTRATION FORM (FOREIGN DELEGATES) WELCOME LOCAL DELEGATES! IMPORTANT REMINDERS: Before proceeding with the registration form, please ensure you have a soft copy of your proof of payment in JPEG/JPG or PNG format ready. Details of the proof of payment should be filled in the form below. You will need to upload it as part of the registration process. Thank you! Back Next LOCAL DELEGATES REGISTRATION FORM FULL NAME* PrefixFirst NameMiddle NameLast NameSuffix EMAIL* [email protected] Cellphone Number* Please enter a valid cellphone number. PRC LICENSE NUMBER* PRC LICENSE EXPIRY DATE (DD/MM/YYYY)* /Day /MonthYearDate MEMBERSHIP* FellowDiplomateAssociateResident-In-Training PARM CHAPTER* N/A for ResidentsNCRStarsNorth LuzonVisayasMindanao INSTITUTION (FOR RESIDENTS ONLY)* CSMC - Cardinal Santos Medical CenterOSMAK - Ospital ng MakatiPOC - Philippine Orthopedic CenterSLMC - St. Lukes Medical Center (QC)TMC - The Medical City (Pasig)UP-PGH - Philippine General HospitalUSTH - University Santo Tomas HospitalVMMC - Veterans Memorial Medical CenterVLMC - Victoriano Luna Medical Center REGISTRATION FEE* prevnext( X ) EARLY BIRD RATEOctober 15, 2024 until December 15, 2024 FreePHP CATEGORY Please select Fellow Diplomate Associate Resident-In-Training REGULAR RATEDecember 16, 2024 until January 20, 2025 FreePHP CATEGORY Please select Fellow Diplomate Associate Resident-In-Training ON-SITEFebruary 20-23, 2024 FreePHP CATEGORY Please select Fellow Diplomate Associate Resident-In-Training PLEASE UPLOAD YOUR PROOF OF PAYMENT HERE* Back Next Submit Should be Empty: