28F Unit 2803 Summit One Tower 530 Shaw Boulevard, Mandaluyong City

Telephone: (+632) 8534-6787 Telefax: (+632) 8534-6789 E-Mail: ulapnatsec@gmail.com, secretariat@ulap.net.ph

Website: www.ulap.net.ph Facebook: www.facebook.com/ulap.net.ph

9th United Cities and Local Governments Asia Pacific Congress 2023
13-15 November 2023 | Yiwu, China

PARTICIPANT REGISTRATION FORM

Please use CAPITAL LETTERS or TYPE and return this form to:
ulapnatsec@gmail.com

Registration Details

Family Name: …………………………………….. Given Name: ……………………………………………

Middle Name: …………………………………….. Date of Birth: ……………………………………….….
Nationality: ……………………………………….. LGU Representation: …………………………………
Passport Number: ………………………….. Expiration Date: ………… Place of Issuance: ………………
Residential Address:
Zip code: ………………. Town: ….……………… Country: ………………………………………………….
Phone: …………………………………………….. Fax: ………………………………………………………
Email: ………………………………………………
☐ Specific diet requirements (vegetarian, allergies):
…………………………............................................
☐ Specific assistance needed (mobility assistive device, braille system): …………………………...........

Accommodation Requirements
Occupancy: ☐ Single ☐ Double
Bed configuration: ☐ Large bed ☐ Twin beds
Smoking preference: ☐ Smoking ☐ Non-smoking
Other personal room accommodation request/s:
………………………………………………………………………………………………………………….…
Airfare Arrangements
Preferred Date of Departing Flight (MNL-YIW): ☐ 12 November 2023 ☐ Others …………
Preferred Time of Departing Flight (subject to airline availability): ………………………………………….
Preferred Date of Returning Flight (YIW-MNL): ☐ 16 November 2023 ☐ 17 November 2023
☐ Others ……….
Preferred Time of Returning Flight (subject to airline availability): ………………………………………….
Emergency Contact Details
In case of emergency, please contact:
Full Name: ……………………………………………………………………………………………………….
Relationship: …………………………………………………………………………………………………….
Address: …………………………………………………………………………………………………………

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 28F Unit 2803 Summit One Tower 530 Shaw Boulevard, Mandaluyong City
Telephone: (+632) 8534-6787 Telefax: (+632) 8534-6789 E-Mail: ulapnatsec@gmail.com, secretariat@ulap.net.ph
Website: www.ulap.net.ph Facebook: www.facebook.com/ulap.net.ph

Mobile Number: …………………………………………………………………………………………………

Registration Fee and Modes of Payment

Registration Fee (inclusive of roundtrip airfare, 12-16 November accommodations, airport transfers,
meals, and coordination fees):
☐ Package 1: For ULAP National Executive Board Members and Other Active Paying
Members
Discounted Rate: PhP 130,000.00 (PhP 20,000.00 discount)

☐ Package 2: For non-ULAP National Executive Board Members and Non-Active

Paying Members
Rate: PhP 150,000.00
Mode of Payment:
☐ Cheque (Payable to Union of Local Authorities of the Philippines, Inc.)
☐ Bank Transfer/Deposit (All charges to be borne by principal)
Account Name: Union of Local Authorities of the Philippines, Inc.
Account Number: 1238-7000-1394
Bank Name and Branch: Philippine National Bank (PNB)-Highway Hills
Swift Code: PNBMPHMM
Billing Information
Local Government Unit:
IF DIFFERENT FROM ABOVE:
Contact Person:
Position: Department:
Address:
Zip code: City: Country:
Phone/Mobile: Fax:
Email: Purchase Order # or other reference:
IMPORTANT: Hotel and flight reservations should be made ONLY after receipt of registration confirmation
and are subject to price changes . If you have not received your confirmation within two (2) working days,
please contact the ULAP Secretariat.

Data Protection Statement and Image Rights

By filling out the registration form, the participant gives consent for ULAP to process the data
provided within the framework of the event and allow photographs and videos to be made during the
full duration of said activity. This includes, unless registered participants object, all handling needed
for the applicant’s participation at the event and for the drafting of a list of participants which will be
distributed at the event, and placing photographs and videos in the gallery of ULAP official website
and social media accounts, in the Fulcrum newsletter, for articles to be forwarded to newspaper and
media other media outlets, or in any other web/printed publication.
Right of access: applicants have a right to access and ask for changing or deleting their personal
data, which will be kept by ULAP.

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