| Personal Particular
Student's Name _________________________________________________
Gender Male/Female
Date of Birth: __________________ Age _________
*Parent's Name _____________________________
*Relationship __________
Address _________________________________________________________
__________________________________________Postal
Code ___________
Phone (Home) ____________________
*Office/Mobile___________________
Email Address (please
write or type clearly)
Primary email : _________________________________________________
Alternative email : _________________________________________________
Course and Payment
detail:
| Course Duration |
Months : [
] |
|
|
Course fee |
S$_______________ |
| Total fee |
|
S$_______________ |
| Cheque or Bank Ref |
__________________ |
Date: _____________ |
How did you get to know us
? _______________________________________
Your internet connection
(please tick) : Dialup [ ] Broadband [
]
Please send us a recent passport
size or larger photo by post or email as JPEG file (800x600) for personal
page setup. |