Office of the President of the

Philippines

NATIONAL YOUTH
COMMISSION
The Voice and Advocate of the Youth
REGISTRATION AND CONFIRMATION OF ATTENDANCE SLIP

ACTIVITY TITLE: SANGGUNIANG KABATAAN NATIONAL SUMMIT 2022

DATE: APRIL 7-10, 2022

PERSONAL INFORMATION

NAME OF RAVENN B. MIRANDA

SK OFFICIAL:

PRIMARY 09913899470 ALTERNATE 09989366096

CONTACT CONTACT
NUMBER: NUMBER:

GENDER: FEMALE EMAIL ravenn.miranda@gm

ADDRESS: ail.com

COMPLETE L163 J4 INTERIOR PUROK UNO MENDIOLA ST. ALABANG MUNTINLUPA

ADDRESS: CITY

SK PEDERASYON PRESIDENT:

PROVINCE: ________________________________________

CITY/MUNICIPALITY: MUNTINLUPA CITY

SK BARANGAY CHAIRPERSON: BARANGAY: ALABANG
Please list any medical conditions that may affect your training (This includes allergies, asthma,
past or present injuries and/or surgeries): __________________________________________
____________________________________________________________________________
EMERGENCY CONTACT

NAME: MARIA TERESA V BARES RELATIONSHIP MOTHER

ADDRESS: SAME AS ABOVE CONTACT 09236664851

NUMBER:

I would like to signify and confirm my participation in the Sangguniang Kabataan National
Summit 2022 to be held on April 7-10, 2022 at Baguio City.
Moreover, I understand that once my participation has been confirmed and accepted, I am
responsible for paying the costs for the allocated slots if I do not use the food and
accommodation provided by the National Youth Commission.

______________________________
Signature over Printed Name

Note: Kindly upload this form when applying through https://bit.ly/2022SKNationalSummit, and
bring a printed copy during on-site registration. Accomplish the form on or before 27 March
2022, 11:59 pm.
FOR NYC USE ONLY:
____ ACCEPTED ___ DECLINED due to: _____________ Date:_____________
3rd Flr. West Insula Building, #135 West Avenue cor. EDSA,
Brgy. Bungad, Quezon City, Philippines
Direct lines: (02) 4268475 / (02) 4268899 / (02) 4268733 /
(02) 4268760 / (02) 4268676 / (02) 4268885
Trunk lines: (02) 4268536 / (02) 4268479
Email: info@nyc.gov.ph Website: www.nyc.gov.ph