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Student Details

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Student Name*:

Gender*:

School Name*:

Phone Number*:

Date of Birth*:

Level*:

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Email*:

Address*:

Postal Code*:

Parent/Guardian Details

Mobile Number*:

Parent/Guardian Name*:

Relationship*:

Email*:

Class Registration

Which type(s) of class do you want to enroll in?*

*Please fill in student's level before selection.

Interactive Class

1-to-1 Lesson

Power Focus Group

Booster Session (March)

Booster Session (June)

Which session(s) are you able to join?

Please indicate as many slots as possible.

Interactive Class:

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Error: Two or more identical slots!

1-to-1 Lessons:

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Error: Two or more identical slots!

Power Focus Group:

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Error: Two or more identical slots!

Booster Session (March):

Mon

Tue

Wed

Thu

Fri

Booster Session (June):

Week 1:

Mon

Tue

Wed

Thu

Fri

Week 2:

Mon

Tue

Wed

Thu

Fri

Promo Code (if any):

How did you know us*?

Remarks:

Please double-check your submitting info.

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