2022 Midterm Programmes Enrollment Form
For students going to K1 to P4
Parent Information
Parent's Name
*
Mr.
Mrs.
Ms.
Prefix
First Name
Last Name
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
Postal / Zip Code
Email
*
example@example.com
Secondary Email
example@example.com
Emergency Contact Person
First Name
Last Name
Phone Number
Preferred Method of Communication (Please select one or more)
*
Telephone
WhatsApp
Email
Other
How did you hear about JEMS?
Friend (Please state name in 'Other')
Website
Facebook
Instagram
Printed Media (Newspapers/magazines)
Other
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Student Information
Child's Name
*
First Name
Last Name
Date of Birth
*
/
Day
/
Month
Year
Date
Gender
*
Male
Female
School
*
Grade Level
*
Select grade level
K1
K2/Reception
K3/Y1
P1/Y2
P2/Y3
P3/Y4
P4/Y5
School level in 2022-2023
Food Allergies or Medical Concerns, if any
Interests
Additional Remarks, if any (i.e. Learning needs)
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Junior Level Workshops (K1-K3)
Workshop Fees:
*
$1500 (3 workshops)
$2250 (5 workshops)
$2940 (7 workshops)
$3800 (10 workshops)
5th-7th Oct:
5th Oct (Wed)
6th Oct (Thu)
7th Oct (Fri)
11th-14th Oct:
11th Oct (Tue)
12th Oct (Wed)
13th Oct (Thu)
14th Oct (Fri)
18th-21st Oct:
18th Oct (Tue)
19th Oct (Wed)
20th Oct (Thu)
21st Oct (Fri)
25th-28th Oct:
25th Oct (Tue)
26th Oct (Wed)
27th Oct (Thu)
28th Oct (Fri)
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Admiralty: Core Level Workshops (P1-P4)
P1-P4: $2250 (3 workshops) / $3400 (5 workshops) / $4960 (8 workshops)
Workshop Fees:
*
$2250 (3 workshops)
$3400 (5 workshops)
$4960 (8 workshops)
5th-7th Oct (Wed-Fri):
5th Oct (Wed)
6th Oct (Thu)
7th Oct (Fri)
11th-14th Oct:
11th Oct (Tue)
12th Oct (Wed)
13th Oct (Thu)
14th Oct (Fri)
18th-21st Oct:
18th Oct (Tue)
19th Oct (Wed)
20th Oct (Thu)
21st Oct (Fri)
25th-28th Oct:
25th Oct (Tue)
26th Oct (Wed)
27th Oct (Thu)
28th Oct (Fri)
Workshop Fee:
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Terms & Conditions
Promotional Code / Voucher No. (if any):
Payment Options
*
Cheque payable to: "JEMS Education (HK) Ltd." (mailed or delivered in person to our centre)
Bank Transfer: HSBC Account #400 631313 838 (proof of payment/deposit slip emailed to info@jems.com.hk)
FPS Identifier: info@jems.com.hk (email proof of payment/deposit slip to info@jems.com.hk)
Parent Signature
*
Date
-
Day
-
Month
Year
Date
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Submit
Should be Empty: