Course Registration Form

Student Registration Form 学生登记表

Fill out the form carefully for registration 认真填写表格进行注册
Student Name 学生姓名*

English Name 英文名Given Name 给定的名称Family Name 姓
Parent Name *

English Name 英文名Given Name 给定的名称Family Name 姓
Birth Date

MonthDayYear
Gender
E-mail 电子邮件*
example@example.com
Courses 培训班*
Courses Package 培训班*
Goals for your student 学生的目标
Example: Speaking in full sentences, conversational English, phonics 示例：用完整的句子说话、会话英语、语音学
My Products
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Free Demo Class
Free Trial Demo Class

$ Free



1 Class
Single Class - 25 minutes

$25.00



10 Class Package
10 classes - each class is 25 minutes $50 savings

$200.00



Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Student Registration Form 学生登记表