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IMPETUS 2024 Online Registration Form

*BEFORE YOU PROCEED, CONFIRM THAT YOU HAVE READ AND UNDERSTOOD THE REGISTRATION PROCEDURES

I have read and understood the REGISTRATION PROCEDURES for IMPETUS 2024.

*Required fields

Payment details

1. Registration Category*

2. Upload Proof of Identification* 
(Upload image file: .JPG, .PNG, etc. | Max File Size 15MB)

Select File

For PPTA members, upload PPTA ID
For non-PPTA, upload an official ID.
For students, upload your school ID.

3. PPTA Membership Number*
For non-members, enter N/A.

4. Registration Type*

5. Inclusive Days of Registration

6. Please indicate if you have a special registration rate*

7. Deposit or Transaction receipt*
(Upload image file: .JPG, .PNG, etc.)

Select File

8. Date and Time of Payment*

Personal information

*Required fields

PRC License number*

For those who are not PRC-registered or are undergraduate students, enter N/A.

NOTE: The name that you will provide here shall appear exactly on your Certificate of Attendance.

Last Name*

Given Name(s)*

Middle Initial

Area(s) of practice*

Sex*

Active Email address*

Contact number*

Number only. Do not put any symbols.

Name of institution of current affiliation*

Regional location of work or studies*

Official receipt information

*Required fields

Do you want to receive an official receipt of payment for this convention?*

Purpose of Requesting an Official Receipt

Name of person or institution to appear on the receipt

Amount paid

Number only. Do not put any symbols.

An error occurred.

Accomplish all required(*) fields.

Recheck uploaded files; these should be IMAGE FILES and must not exceed 15MB.

Try submitting again.

Wait around 5 seconds until you are redirected to an acknowledgement page.

Speed of submission depends on the speed of your internet connection and size of the files that you are uploading.

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