PCG Vancouver Emergency Response Mapping Registry

Privacy Notice: Information collected using this form will be used exclusively by the Philippine Consulate General in Vancouver to By filling out this form, you consent to providing this information for the purposes stated above.

The data collected in this registry is managed and protected in accordance with the relevant provisions of RA 10173 (Philippine Data Privacy Act of 2012).

By filling out this form, you consent to providing this information for the purposes stated above.

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Email *
Name (LAST NAME, FIRST NAME MIDDLE NAME, eg. DE LA CRUZ, JUAN SANTOS) *
Birth Date *
MM
/
DD
/
YYYY
Sex *
Telephone Number *
Street Address (House/Building No., Street Name, .e.g. Suite 600, 999 Canada Place) *
City *
Province / Territory *
Postal Code *
If you cannot be reached, please indicate who we can contact in Canada during emergencies  and their contact information: *
Please indicate the name and contact information of your next of kin in the Philippines: *
Please check the status that applies to you: *
Please indicate the type of occupation or profession (including part-time work) you are currently engaged in (e.g. nurse, engineer, food service worker, etc): *
Do you wish to receive news, updates, and invitations to activities by Philippine Consulate General in Vancouver through email? *
A copy of your responses will be emailed to the address you provided.
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