Course Selection Form

Course Selection Form

"Key Campus"
Student Name

First NameLast Name
Student ID
Issued by institute
Reference by
Centre
Grade/Class Level
Term

April ( Full Term)July (Full Term)2 Year Programs12 Month Program6 Month Program3 Month Program1 Month ProgramShort TermSummer HolidaysCrash CourseEntrance Exam PrepOthers
School Year
School Board
Phone Number ( WhatsApp Number for Notifications & Updates)
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name

First NameLast Name
Parent/Guardian hone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com

Main Course (Please select only 5 courses)

Alternate Course (Please select only 5 courses)