REGISTRATION FORM

Name: Birthday:   Gender:
Home Address:
Home Phone: Fax: Mobile:
Email: YM ID:


PROFESSIONAL INFORMATION
Owns a Business Employed and Has part-time business Self-employed
Company: Years in Service:
Nature of Business:
Position: Department/ Division:
Company Address:
Phone: Fax: Mobile:
Email: YM ID:


MEMBERSHIP AND ATTENDANCE BACKGROUND
Member Guest
Officer Position:
How long have you been a member?  
Are you aware of the different functions and activities of this organization?
Yes No
What activities are you actively involved with? (Please check accordingly).
Meetings Seminars Convention
Sports, Culture & Arts Socializing/Networking
Others (Please specify):
Why do you join these activities?

When did you last join an activity? (Please choose accordingly).
Last Month Two months ago 6 months ago
More than 6 months but less than a year ago More than a year ago
Others (Please specify):

What kind of activity did you last participate in? (Please choose accordingly).
Meetings Seminars Conventions
Sports, Culture & Arts Socializing/Networking
Others (Please specify):

What motivates you to join these activities?

How were you invited to join these activities? (Please check accordingly).
Print Advertisement Through A Friend Social Networking Websites
Email SMS/ Text Forums
Others (Please specify):

AREAS OF INTEREST
What activities or topics would you be most interested with?

LOGISTICS
Where would you prefer to hold such activities?

TIME AND AVAILABILITY
When would be the best time to hold such activities?
    

Kindly remit the membership fee of Php 1,500.00 to the following bank details:
Company Name : Network for Enterprising Women, Manila Assn, Inc.
Account #: BPI CA#4481-0051-46,
Please fax your deposit slip to 908-2555 with your name and contact number.