registration form philippine institute of civil engineers...

PHILIPPINE INSTITUTE OFCIVIL ENGINEERS, INC.

REGISTRATION FORM18th Regions IV-A & IV-B Technical Conference

10-11August 2017Development Academy of the Philippines,

Tagaytay City, Cavite

NAME __________________________________________________________

PRC NO. ____________________ EXPIRY DATE _________________________

DATE OF REGISTRATION ___________________________________________

CHAPTER _______________________________________________________

MEMBERSHIP TYPE ( ) Associate ( ) Regular ( ) Life ( ) Fellow

SECTOR ( ) Government ______________________________________

( ) Private ___________________________________________

Others ___________________________

HOME ADDRESS _________________________________________________

_______________________________________________________________

TEL NO. ___________________________ FAX NO. _____________________

CELLPHONE NUMBER _____________________________________________

COMPANY NAME ________________________________________________

POSITION ______________________________________________________

COMPANY ADDRESS ______________________________________________

_______________________________________________________________

TEL NO. ________________________________________________________

FAX NO. ________________________________________________________

E-MAIL _________________________________________________________

SIGNATURE ______________________________________________________

PAYMENT VALIDATION (to be filled-up by the Secretariat)

AmountPaid P _________________ OR No. _________________________

Cashier Name __________________ Claim Stub Issued _______________

Received By: _____________________________________________________

10-11 August 2017Development Academy of the Philippines,


PARTICIPATING CHAPTERS:CAVITE (HOST), BATANGAS, LAGUNA, QUEZONPROVINCE, RIZAL, SAN PABLO CITY, MARINDUQUE,OCCIDENTAL MINDORO, ORIENTAL MINDORO,PALAWAN AND ROMBLON

A Continuing Professional Development Programof the Philippine Institute of Civil Engineers, Inc.

by the Regional Conferences Committee

PHILIPPINEINSTITUTEOF

PHILIPPINEIN

STITUTE

OF

CIVILEN

GIN

EERS,INC.

10-11 August2017

Development A

cademy of the

Philippines, Tagaytay City, C

avite

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NAME __________________________________________________________



CHAPTER _______________________________________________________



( ) Private ___________________________________________

Others ___________________________

HOME ADDRESS _________________________________________________

_______________________________________________________________

TEL NO. ___________________________ FAX NO. _____________________


COMPANY NAME ________________________________________________

POSITION ______________________________________________________

COMPANY ADDRESS ______________________________________________

_______________________________________________________________

TEL NO. ________________________________________________________

FAX NO. ________________________________________________________

E-MAIL _________________________________________________________

SIGNATURE ______________________________________________________




Received By: _____________________________________________________







PHILIPPINEIN

STITUTE

OF

CIVILEN

GIN

EERS,INC.

10-11 August2017

Development A

cademy of the


avite

If un

delivered

, please retu

rn to

:*T

he P

ICE

Natio

nal H

eadq

uarters

Office

PIC

E B

uild

ing

#4

Alb

any Street,

Cu

bao

, Qu

ezon

City 1

10

9 P

hilip

pin

esT

el. No

s. 70

9-3

93

6 to

38

Tel/Fax N

os. 7

09

-34

15





NAME __________________________________________________________



CHAPTER _______________________________________________________



( ) Private ___________________________________________

Others ___________________________

HOME ADDRESS _________________________________________________

_______________________________________________________________

TEL NO. ___________________________ FAX NO. _____________________


COMPANY NAME ________________________________________________

POSITION ______________________________________________________

COMPANY ADDRESS ______________________________________________

_______________________________________________________________

TEL NO. ________________________________________________________

FAX NO. ________________________________________________________

E-MAIL _________________________________________________________

SIGNATURE ______________________________________________________




Received By: _____________________________________________________







PHILIPPINEIN

STITUTE

OF

CIVILEN

GIN

EERS,INC.

10-11 August2017

Development A

cademy of the


avite

If un

delivered

, please retu

rn to

:*T

he P

ICE

Natio

nal H

eadq

uarters

Office

PIC

E B

uild

ing

#4

Alb

any Street,

Cu

bao

, Qu

ezon

City 1

10

9 P

hilip

pin

esT

el. No

s. 70

9-3

93

6 to

38

Tel/Fax N

os. 7

09

-34

15





NAME __________________________________________________________



CHAPTER _______________________________________________________



( ) Private ___________________________________________

Others ___________________________

HOME ADDRESS _________________________________________________

_______________________________________________________________

TEL NO. ___________________________ FAX NO. _____________________


COMPANY NAME ________________________________________________

POSITION ______________________________________________________

COMPANY ADDRESS ______________________________________________

_______________________________________________________________

TEL NO. ________________________________________________________

FAX NO. ________________________________________________________

E-MAIL _________________________________________________________

SIGNATURE ______________________________________________________




Received By: _____________________________________________________







PHILIPPINEIN

STITUTE

OF

CIVILEN

GIN

EERS,INC.

10-11 August2017

Development A

cademy of the


avite

If un

delivered

, please retu

rn to

:*T

he P

ICE

Natio

nal H

eadq

uarters

Office

PIC

E B

uild

ing

#4

Alb

any Street,

Cu

bao

, Qu

ezon

City 1

10

9 P

hilip

pin

esT

el. No

s. 70

9-3

93

6 to

38

Tel/Fax N

os. 7

09

-34

15

For more details, visit, call, text or send e-mail to:The PICE National Headquarters OfficePICE Building, 4 Albany Street, Cubao, Quezon CityTel. Nos. (02) 7093936 to 38/ (02) 7093505/(02) 7093429/7093940Tel/Fax Nos. (02) 7093415Cell Nos. (0917) 3152765/(0922) 3022296 / (0928) 3410623Email add: [email protected]: www.pice.org.ph

ENGR. CESAR S. RAMOSPICE Region IV-A CoordinatorC.S. Ramos Construction258 Bucandala, Imus, CaviteTel/Fax No. (046) 471-1927Cell Nos. (0917) 805-2594 /

(0925) 721-5065Email add: [email protected]

PICE CAVITE CHAPTER (HOST)ENGR. NOLASCO V. BAYOTChapter PresidentAmadeo Municipal Hall, Pob.Amadeo, CaviteCell No. (0917) 577-2999Email add: [email protected] Sec. Engr. Rodney Costelo(0936) 875-1620 / (0908414-4616)Email add: [email protected]

PICE BATANGAS CHAPTERENGR. LEON M. MANALOChapter PresidentBatangas City Engineers OfficeP. Herrera St. Poblacion 6, Batangas City, BatangasTel No. (043) 706-0995Cell No. (0920) 926-7654 Engr. ManaloEngr. Jelyn P. Dinglasan, Chap SecretaryCell No. (0917) 561-5620Tel. No. (043) 723-3023Email add: [email protected] /[email protected] / [email protected]

PICE LAGUNA CHAPTERENGR. JERRY A. MALIXIChapter PresidentOffice of the Municipal EngineerBrgy. Pauli II, Rizal, LagunaCell No. (0917) 823-6669/(0922) 885-2319Email add: [email protected]

PICE QUEZON PROVINCE CHAPTERENGR. ARMANDO O. VALDEAVILLAChapter President58 Jose Rizal Street, Tayabas City, Quezon 4327Cell No. (0922) 881-9889 Engr. ValdeavillaEmail add: [email protected] No. Chapter SecretaryEngr. Ramela B. Ramirez (0933) 927-6165

PICE RIZAL CHAPTERENGR. CARLOS S. GERONIMOChapter President4 P. Sandoval Street Burgos, Rodriguez, RizalCell No. (0919) 586-4307 Engr. GeronimoEmail add: [email protected]

PICE SAN PABLO CITY CHAPTERENGR. CLETO M. ARANA JR.Chapter President275 Brgy. San Cristobal, San Pablo City, LagunaCell Nos. (0927) 601-6710 / (0999) 482-8204Email add: [email protected]

PICE MARINDUQUE CHAPTERENGR. RAMEL J. NARANJOChapter PresidentDepartment of Public Works and HighwaysBangbangalon, Boac, MarinduqueCell No. (0921) 960-6092 Engr. NaranjoEmail add: [email protected]

PICE OCCIDENTAL MINDORO CHAPTERENGR. ROBERTO G. DIMAYACYACChapter President1225 J. Daño St., Sablayan, Occidental MindoroFax No. (043) 727-2881Cell No. (0920) 932-7705 Engr. DimayacyacEmail add: [email protected]

PICE ORIENTAL MINDORO CHAPTERENGR. ERWIN DG. UMALIChapter PresidentPICE Building, Provincial Capitol ComplexCalapan City, Oriental Mindoro 5209Tel/Fax No. (043) 288-1873Cell No. (0921) 839-5166 Engr. UmaliCell No. of Engr. Virgilio A. Santos, Liaison Officer(0999) 998-5275/(0917) 447-9568

PICE PALAWAN CHAPTERENGR. ROYTHER P. PABLICOChapter PresidentPICE Building, DPWH Compound, Rafols Road,Brgy. San Sta. Monica, Puerto Princesa City, PalawanCell Nos. of Engr. Pablico(0920) 835-8518 / (0977) 707-9398Email add: [email protected]

PICE ROMBLON CHAPTERENGR. DANTE F. FETALVEROChapter PresidentC/o Engr. Winona F. FaderogayaDPWH Romblon District Engineering OfficeOdiongan, Romblon 5505Email add: [email protected] No. (0919) 257-2648 Engr. Faderogaya(0939) 815-9071 Engr. Fetalvero

CONFERENCE FEEIncludes Kit,Technical Papersand Lunch/Snacks

Without hotelaccommodation

With hotelaccommodation

PhP 1,500.00 PhP 2,000.00

“LIMITED SLOTS ONLY” NO ON SITE REGISTRATIONPLEASE PAY BEFORE JULY 31, 2017Cancellation – Any Delegate who has paid the necessary Conference Fee but willbe unable to attend may submit the name of a substitute or replacement at anytime, in writing, at least seven (7) days before the Conference. The fee mayberefunded in full if cancellation is done 10 days before the conference. Ifcancellation is made 5 days before the conference (with no replacement), therefund will be subject to 10% service charge.

ENGR. JOSEFINO M. MELGAR, JR.PICE Region IV-b CoordinatorDPWH Mindoro Occidental DistrictEngineering OfficeMamburao, Occidental MindoroCell Nos. (0918) 946-9187Email add: [email protected]

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TECHNICAL CONFERENCE(Tentative Program)

10August2017 (Thursday)7:30 AM Conference Registration

9:00 AM Opening Ceremony Invocation National Anthem Introduction of Personages & Chapter

Delegates Welcome Remarks Opening of the Conference Introduction of Keynote Speaker Keynote Address Presentation of Plaque of Appreciation

by the Regional Coordinator andChapter Presidents

Acknowledgement

11:00 AM Visual Screening for Structural Assessment ofBuildings

12:00 NN Luncheon/Interaction of Delegates

1:30 PM Building Information Modelling

2:30 PM Project and Construction Management

3:30 PM Coffee Break

3:45 PM Geotechnical Engineering

4:45 PM Performance-Based Seismic Design

5:45 PM End of Session

6:00 PM Meeting with the Chapter Presidents andRegional Coordinator

7:00 PM Fellowship Night and Entertainment

11Friday2017 (Friday)9:00 AM Coastal Engineering

10:00 AM Coffee Break

10:15 AM Orientation on CPD and ASEAN Membership

11:15 AM Raffle and Closing Ceremony

PARTICIPATING CHAPTERS

2017 National Board of DirectorsMARIA CATALINA E. CABRAL, Ph.D.President

CLEMENTE A. IBO1st Vice-President

ERDSAN RENE S. SUERO2nd Vice-President

APRIL FRANCES AGATHA G. FLORESSecretary

RESTITUTO C. BAUTISTATreasurer

ANGEL T.TORREJONAuditor

DIMAS S. SOGUILONBusiness Manager

ROMEO C. ROSARIOP.R.O.

DirectorsMARIANO R. ALQUIZAROSEIN A. ANCHETA, JR., Ph.D.CARY H. BEATISULAIXOPERIO R. BONZONADOR G. CANLASEVELYN B. CAYATANGEL N. JAURIGUE

THE CONFERENCE ORGANIZERS

REGIONAL CONFERENCES COMMITTEEChairman: ERDSAN RENE S. SUERO

Vice- Chair: ADOR G. CANLAS

Members:ROSEIN A. ANCHETA, JR. Ph.D.

CARY H. BEATISULACLEMENTE A. IBO

ROBERT S. LICUP, Ph.D.Overall Coordinator

Council of Advisers (Past Presidents)ERNESTO S. DE CASTRO, Ph.D.Immediate Past President

EUGENIO R. PIPO JR.DAVID G. SANCHEZROMEO S. MOMOBENITO M. PACHECO, Ph.D.JAIME A. PACANAN, Ph.D.VENANCIO I. BESAVILLA, JR.WILLY T. GOJUANITO P. ABERGASPRIMITIVO C. CAL, Ph.D.MOCAMAD M. RAKI-IN, SR.PETER N. AVENTAJADOMANUEL M. BONOANEFREN H. SISONBASHIR D. RASUMANNELSON Q. IRASGADAVID M. CONSUNJIANGEL L. LAZARO III, Ph.D.ROMEO S. CAPARROSChancellor, College of FellowsDAVID G. SANCHEZExecutive SecretaryROBERT S. LICUP, Ph.D.National Administrative Officer

registration form philippine institute of civil engineers...

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