PROGRAM REGISTRATION FORM 2015
(January to June)
Please check the certificate course(s) you are enrolling in:
✓
Courses
Training Dates
Fee
Certificate Course in Facilitating
Adult Learning
January 28-30 & February 2
P 18,000
May 6-8 & 12
P 18,000
Certificate Course in the
Foundations of Organization
Development
May 18-22
P 34,500
Certificate Course in Talent
Management
February 7, 14, 21 & 28
P 18,000
Certificate Course in Learning
Design and Evaluation
March 9-10, 25-27 & 30
P 27,000
Certificate Course in Strategic
Human Resource Business
Partnering
March 17-20
P 18,000
Please check the short course(s) or elective course(s) you are enrolling in:
✓
Courses
Training Dates
Fee
Training Assistant Development
Program
February 26-27
P 9,000
May 14-15
P 9,000
Certificate Course in
Competency-Based Human
Resource Management
April 16-17 & 20-21
P 18,000
Certificate Course in Employee
Engagement and Well-Being
April 27-30
P 18,000
Short Course in Essential Skills in
People Management
May 27-29
P 13,500
Please fill-out the following information:
Ateneo CORD, Department of Psychology, School of Social Sciences, Loyola Schools
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PERSONAL DATA
NAME:
NICKNAME:
AGE:
CIVIL STATUS:
GENDER:
BIRTHDAY:
HOME ADDRESS:
CONTACT NO/S:
MOBILE NO:
TELEPHONE NO/S:
EMAIL ADDRESS:
PRESENT HOME ADDRESS:
EMPLOYMENT
EMPLOYER/BUSINESS
NAME:
EMPLOYER/BUSINESS
ADDRESS:
POSITION
TITLE/DESIGNATION:
MAIN RESPONSIBILITY:
ADDRESS:
OFFICE TELEPHONE NO/S:
FAX NO/S:
EMAIL ADDRESS:
Ateneo CORD, Department of Psychology, School of Social Sciences, Loyola Schools
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EDUCATION
UNDERGRADUATE
COURSE:
GRADUATE COURSE:
FINANCE
CONTACT PERSON FOR
PAYMENT COLLECTION:
TELEPHONE NO/S:
EMAIL ADDRESS:
*If you will be bringing a vehicle during the training program, kindly provide the
following information:
Name of Car Owner: _______________________________
Plate No._______________________
Model and Make of the car/s: ___________________________
Ateneo CORD, Department of Psychology, School of Social Sciences, Loyola Schools
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ADMISSION REQUIREMENTS:

All college graduates are eligible to attend the programs.

For individuals completing the diploma programs, any of following documents
must be submitted:
 Photocopy of Transcript of Records (TOR)
 Photocopy of College Diploma
 Letter of Certification that participant is a graduate of the college
or university

A letter of intent to enroll in the diploma program must be submitted to the
Associate Director for HRMD, Ms. Sarah Rebecca G. Gonzaga.

The documents must be submitted together with the registration form before
the start of the workshop date.
TERMS OF PARTICIPATION

Your reservations will be confirmed by CORD three working days before the
workshop date. Please send completed form to cord.soss@ateneo.edu or fax
to 426-5931 not later than three working days before the workshop date.

Cancellations made less than 3 working days prior to the program’s start date
or failure to appear on the seminar date are both subject to a cancellation fee
of 15% of the total program fees.

Ateneo CORD reserves the right to reschedule or cancel any certificate course
if the minimum number of participants is not met.

Substitutions are allowed and may be made prior to the start of the workshop
date.

Fees are inclusive of participant materials, lunch and snacks.

Payment should be made before or during the program date.
o Checks must be made payable to Ateneo de Manila University CORD. Please deliver checks directly to Ateneo CORD.
o Bank deposits must be addressed to the
Account Name: Ateneo de Manila University
Bank: BPI
Account Number: 3081-1125-83 (current)
Pls. email/fax us a copy of the deposit slip with the company contact details
indicated

Failure to pay during the specified date will render the account as past due.
Past due interest rate is charged daily for the outstanding balance.
Ateneo CORD, Department of Psychology, School of Social Sciences, Loyola Schools
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
For participants availing of the early bird discounts, a reservation deposit of at
least 20% of the total cost must be made (total program fees – early bird
discount), 2 weeks prior to the workshop date.

Participants enrolled in the diploma and certificate programs are expected to
meet performance standards and requirements which will be explained on the
first day of the workshop.

Participants permit Ateneo CORD to use any data and pictures gathered
during the programs for the purposes of academic research, knowledge
generation, and marketing.
I have read the terms of participation regarding this program and I have made an informed
decision that my participation is appropriate for me at this time and will take full responsibility
for my decision to attend.
_______________________
Applicant’s Signature
______________________
Date
IMPORTANT REMINDER: If your organization is nominating you to attend this program, this form
must be signed by the authorized officer to indicate conformity to the terms of participation.
_________________________________
Name of Authorized Officer
_____________________
Position Title/Designation
_________________________________
Signature
_____________________
Date
Ateneo CORD, Department of Psychology, School of Social Sciences, Loyola Schools
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OTHERS
Check payable to ATENEO DE MANILA UNIVERSITY - CORD is enclosed for:
Php (20% reservation deposit)
full tuition
Please indicate if you have any dietary restriction:
________________________________________________
Are you a PAP Member? _____
If yes, do you require a Certificate for CPE points? ______
INFORMATION SHEET
Kindly answer the questions below. Your answers to these questions will help us in
preparing the participant profile sheet. Please use additional sheets if necessary.
1. Briefly describe your learning objectives in attending the program.
2. In what ways do you expect the program to assist you in your job or
responsibilities?
3. List previous short courses or experiences related to the diploma program.
4. How did you learn about this program?
THANK YOU!
Ateneo CORD, Department of Psychology, School of Social Sciences, Loyola Schools
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