(Please write legibly and complete all data required.)

No. Name of Participants

Organization/Affiliation (Indicate if supervisor,

teacher-adviser, officer, member, etc.)

School / Complete Address

Contest (Optional)

Camp Course (Required)

Contact Number (preferably mobile

number)E-mail Address Billeting

1

2

3

4

5

6

7

Region : _____________________ PRE-REGISTERED WALK-INDivision : _____________________

May 1-5, 2011Teachers Camp, Baguio City

PRE-REGISTRATION FORM

DENR-Special Concerns Office-Youth DeskKabataang Sama-Samang Maglilingkod (KASAMA), Inc.

DepED-Center for Students and Co-Curricular Affairs

PARTICIPANTS' COPY

7

8

9

10

11

12

13

14

15

Date : _______________

QUANTITY

NOTE: Participants are requested to confirm their participation on or before April 15 2011 by sending this Pre-Registration Form (PRF)

OTHERS

SOUVENIR MAGAZINES

CERTIFICATES

T-SHIRTS

BAGS

ITEMSID W/ MEAL TICKETS

SignatureSupervisor / Principal /Teacher - Adviser

VERIFICATION CASHIER BILLETING RELEASING

NOTE: Participants are requested to confirm their participation on or before April 15, 2011 by sending this Pre-Registration Form (PRF), thru mail or fax thru telefax numbers (02) 631-8495, (02) 636-3603.

Kindly make (5) copies of a duly filled-up Pre-Registration Form and present to the Registration Committee during the registration.