16th Regional Mid Year Convention

Club Balai Isabel Talisay, Batangas September 20 - 22, 2012

SPONSOR/ADVERTISER Company Name Contact Person Contact Number Address ______________________________ ______________________________ ______________________________ ______________________________

SOLICITOR Name of JPIAn School Contact Numbers Province ______________________________ ______________________________ ______________________________ ______________________________

ADVERTISING LAYOUT ADVERTISING PACKAGE: (Please Check One) ( ) Enclosed is a copy of our advertisement ( ) Solicitor will provide the design / layout *Note: To avoid delay in the production of the Event Souvenir Program, the Advertiser agrees that in case the Advertiser could not submit the design or layout of their advertisement to NFJPIA-R3 on or before August 29, 2012, the Advertiser authorizes the Solicitor to provide the design or layout of the advertisement to NFJPIA-R3 in behalf of the Advertiser. NFJPIA-R3 shall not be liable for any dissatisfaction caused to the Advertiser due to poor quality of the layout submitted by the Solicitor. ( ( ( ( ( ) Whole Page (Colored) ) Whole Page (B&W) ) Half Page ) Quarter Page ) Donor Line Php 3,500.00 Php 2,500.00 Php 1,500.00 Php 1,000.00 Php 500.00

MODE OF PAYMENT ( ) Cash ( ) Check [Bank & Check Number] __________________________________________________ NOTE: Please make check payable to NFJPIA-R3. It shall be noted that the deadline for the payment shall be on or before August 29, 2012. I/We, whose name appears above (sponsor/advertiser), hereby authorize NFJPIA-R3 to publish the advertisement of my/our company or product and we agree to pay the amount of (in words) __________________________ for a page/line th advertisement in the Event Souvenir Program of the 16 REGIONAL MID YEAR CONVENTION of NFJPIA-R3. Should there be no advertisement made, I am entitled into a 30% refund of my/our payment which represents the cost of the service that I/we am/are entitled to receive here into. Signature of Sponsor/Advertiser ______________________ Date ______________________

NFJPIAS COPY

16th Regional Mid Year Convention

Club Balai Isabel Talisay, Batangas September 20 - 22, 2012

SOLICITOR Name of JPIAn School Contact Number Province ___________________________ ____________________________ _______ ____________________ ____________________________

ADVERTISEMENT PACKAGE AVAILED ( ) Whole Page (Colored) AMOUNT PAID (P .00) (in words)_________________________________ (for checks, indicate the Bank Name & check number) ( ) Whole Page (Black &White) ( ) Half Page ( ) Quarter Page ( ) Donor Line

I received from _________________________________________ (sponsor/advertiser) the amount stated herein from the payment of the aforementioned advertisement. I am liable for any responsibility stated therein in the binding contract to deliver the said portion of the payment to NFJPIA-R3 and any fortuitous event that may happen to rendering of such service be credited to my performance as a solicitor. Signature of Solicitor ______________________ Date ______________________

ADVERTISERS COPY