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2010 Summer Courses
Registration Form
If interested in our summer courses, kindly fill up this application form and send to WAGI at telefax number (63-2) 435-9229 or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it / This e-mail address is being protected from spambots. You need JavaScript enabled to view it .
APPLICATION FOR
Kindly check appropriate box for the summer course of your choice:
Gender Fair Education
(April 12 – April 16, 2010)
International Women’s Human Rights
(April 19-24, 2010)
Summer Institute on Migration
(April 26-May 1, 2010)
A. Personal Information
Name: _______________________________________________________________________
Sex: ____________________ Civil Status: ________________Age: __________________
Address: _______________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________
Country: _______________________________ Nationality: _______________________________
Telephone: _____________________________ Fax: __________________________________
Email Address: _____________________________________________________________________
B. Educational Background
Highest Degree Earned: _____________________________________________________________
C. Employment Background
Position: ____________________________________________________________________________
Organization: _______________________________________________________________________
D. What is the relevance of women / gender concerns to your work?
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
E. What is the relevance of human rights or migration concerns to your work?
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
F. List down related trainings on gender, human rights and migration that you have attended for the past 2 years
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
G. Reason(s) for taking this course
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
H. What are your expectations to the course?
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
ADDITIONAL INFORMATION
Dietary Requirements __________________________________________________________
Flight details
Date and Time of Arrival ____________________ Airline details ____________
Date and Time of Departure _________________ Airline details ____________
PAYMENT OPTIONS cash check
For deposit payment, please deposit payment to:
Dollar Account:
Account Name: Miriam College
Name of Bank: Bank of Philippine Islands
Address of Bank: Loyola Branch, Katipunan Road, Quezon City,
1108 Philippines
Savings Account Number: 3084-0375-31
Swift Code: BOPIPHMM
Peso Account:
Name of Bank: Bank of the Philippine Islands (BPI)
Account Name: Miriam College
Savings Account No.: SA # 3081-1112-42
Branch: Loyola Branch, Katipunan Road, Quezon City
CONTACT INFORMATION: Tel: (632) 5805400 loc 3590 / (632) 4359229 / This e-mail address is being protected from spambots. You need JavaScript enabled to view it / This e-mail address is being protected from spambots. You need JavaScript enabled to view it
