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WESM TRAINING ENROLMENT FORM
Please complete this training request form and send by e-mail,
fax, post or delivery to:
PEMC Training and Communications Division
9t
Floor Robinsons Equitable Tower, ADB Avenue, Ortigas Center,
Pasig CityTelephone: (+632) 631-8734 loc.220, 202 or 327 Telefax:
(+632) 634-0985Email: [email protected] or [email protected]
A. COMPANY
DETAILS__________________________________________________________Company
Name :
Short Name : ____________________________________
Business Address :
__________________________________________________________
__________________________________________________________
City/Province : ____________________ Zip Code :
__________________
Telephone No. : ____________________ Facsimile No. :
__________________
Subsidiary/ies (if applicable) : ____________________
Registration Status :
WESM Membership :
Registered
Direct
Applicant
Indirect
Not Registered
Intending
Category (if WESM member) : Generator DU/EC/MSP Bulk-user
Supplier CC
B. TRAINING DETAILS (Please refer to the published training
calendar.)
Course Title
Date of Training
:
:
_____________________________________
_____________________________________
Venue of Training : PEMC Ortigas PEMC Cebu Off-site:
__________________
Ref. No. _________________
MANUELA CORPORATION
MANUELA CORP.
Edsa corner Shaw Blvd., Mandaluyong City
MANDALUYONG 1552718-1886, 718-3462 724-6071
RCOA
APRIL 25 - 26, 2013
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WESM TRAINING ENROLMENT FORM
C. LIST OF TRAINING PARTICIPANTS
No. Name Designation Contact Number E-mail Address
1
2
3
4
5
6
7
8
910
D. CONTACT PERSON
Contact Name :
Designation :
Telephone No. : Mobile No. :
Contact E-mail Address :
E. BILLING INFORMATIONCompany Name :
Billing Address :
Contact Person :
Telephone No. : Facsimile No. :
Company TIN :
F. PAYMENT OPTION (Please choose one.)
Payment should be received at least 14 days prior to the
scheduled date of training.
Check Payable to: Direct Deposit:Philippine Electricity Market
Corporation Account: Philippine Electricity Market Corporation
MICHAEL FRANZ A. ADVINCULA BUILDING ENGR. 0917-5394548
[email protected]
MICHAEL FRANZ A. ADVINCULA
BUILDING ADMIN OFFICER -Electrical
718-1886, 718-3462 0917-5394548
[email protected]
MANUELA CORPORATION
Edsa corner Shaw Blvd., Mandaluyong City
Ms. ROSE DOMINGO
718-1886, 718-3462 724-6071
000-185-616-001
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WESM TRAINING ENROLMENT FORM
9 Floor Robinsons Equitable Tower Bank: Bank of the Philippine
Islands (BPI)ADB Avenue, Ortigas Center, Pasig City Current Account
No.: 4021-0071-24
I have read, understood, and agreed to PEMCs terms and
conditions, as set forth in the BasicWESM Training Description and
Enrolment Guidelines.
Printed Name and Signatureof Authorized Representative
Date
MICHAEL A. ADVINCULA 4/18/13
