CONFIRMATION SLIP

th​
11​ KALINDOGAN National Indigenous Young Leaders Congress
Pamulaan Center for IP Education, University of Southeastern Philippines-Mintal Campus, Mintal, Davao City
October 27-30, 2016

Please put a check (/) in the appropriate box:

❑ YES, I/we would like to participate in the congress.

❑ NO, I/we cannot join the congress.

Name of Institution: ______________________________________________ Address: ________________________________________

Contact Person: _________________________________ Contact Number: ___________________ Email Address: _______________________

List of Confirmed Participants

NAME Designation BIRTHDAY RELIGION GENDER

CONTACT NUMBER EMAIL ADDRESS
(for flight bookings)

Kindly send/fax the duly accomplished form to (02) 6327844 or email to​ ​kringsumalinab@gmail.com;​ ​sanchezianjaypee@gmail.com​;
alindayoclarise@gmail.com​ on or before October 15, 2016.