CONFIRMATION FORM

Please fax the filled-up Confirmation form to 8868768 or call Boyet / Julie at the same number for further questions.

NAME: ATTY. ALEX O. AVISADO, JR.

ROLL NO: 44125

OFFICE ADDRESS: GANA ATIENZA AVISADO LAW OFFICE 3RD FLOOR, HPL BUILDING, NO. 60 SEN. GIL PUYAT AVENUE, MAKATI CITY

OFFICE PHONE NUMBER: 8894263 UP TO 65OFFICE FAX NUMBER: 8440831/2393681

OFFICE EMAIL ADDRESS: ganaandpartners@yahoo.comLPU –COL FACULTY: YES NO I will be attending:

The entire MCLE seminar (Php9,500/36Units)Meals are NOT included

Only certain courses on the following dates and times (Php 900/lecture) Meals are NOT included

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Please choose one regarding lecture handouts:

Please email me soft copies of the materials (recommended)

Please print a hard copy of the materials

FEE TO BE PAID (either bank to bank or to be deliver at LPU): PHP 9,500.00Bank: RCBC SavingsAccount Name: Lyceum of the Philippines University INC.Account Number: 1-279-94050-0(Note: Please send the deposit slip w/ validation)

SIGNATURE: ____________________________________________

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