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Harmony for one and all , The foundation of Genuine Masonic

Fraternity

Links

AnCom 2023 Dumaguete


Registration Form

You are registering to attend the 106th


Annual Communication of the Most
Worshipful Grand Lodge of Free &
Accepted Masons of the Philippines on
April 27 to 28, 2023, in Dumaguete City,
Negros Oriental, Philippines.

Please !ll-up up the form below as


accurately as you can.  You are required to
answer all !elds.  Indicate N/A if you don't
have the information. Do not leave any !eld
blank.

Thank you.

REMINDER!
Please deposit or send your registration
payment before beginning your registration
process. The Transaction Reference Number
and Photo of Transaction/Deposit
Slip or Proof of Payment will be asked when
you register.

Registration Fee - ₱3,500.00.


* Registration Fee is inclusive of Ancom Kits,
Food & Drinks

Please deposit to the bank account below:

Account Name: Rowell Bueno Gaga-a / Gig


Emperado / Dante Angeles
Account Number: 9210-0095-47
Bank Name: Bank of the Philippine Islands
Bank Address: Units 1&2, Uymatiao Bldg, San
Jose Street, Dumaguete City

Personal Info - Step 1 of


2

Name * Su"x

Select
william christopher
chua

Masonic Salutation *
MW RW
VW WBro
Bro

Upload Recent 2x2 ID Photo *

2.4 MB
image.jpg

Please upload a picture of your


recent 2x2 photo here.

Phone * Email *

9153464284
graciachua55@gmail.co

Street Address *

purok 7

Barangay *

datu panas

City *

buug

Province *

zamboanga sibugay

Zip Code *

7009

Masonic District

MD R IX Zamboanga del Sur & Sibugue

3. Sibuguey Valley Masonic No. 246 (Bu

Current Highest Position in


the Lodge/District/Jurisdiction
*

Member

Are you a Voting Delegate? *


Yes

No

Indicate your Size of the Free


AnCom 2023 T-Shirt *
S

XL

2XL

3XL

Mode of Payment *

Online Banking

Payment/Transaction
Reference Number or Code *

Please indicate in this !eld the Referen

This !eld is required.

Proof of Payment Photo *

Click or drag a !le to this


area to upload.

This !eld is required.

Please upload a picture of your


proof of payment photo here.

Next

Lead Lodge: Mt. Kaladias Lodge No. 91

Host District: MD R-XVIII NIR

Uypitching Multi-P…
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Main Venue

Uypitching Multi-Purpose Hall
Barangay Balugo, Valencia
Negros Oriental 6215

 ancom2023dumaguete@grandlodge.ph

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