Student Registration Form
INTAKE 2026
Basic Information
Full Name
First Name
Last Name
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Birth Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
4 years
5 years
6 years
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Email
example@example.com
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Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Emergency Contact
First Name
Last Name
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Permanent Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Relationship
ex. Father, Mother, etc
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Address Of Person To Contact In Case Of Emergency
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Phone Number of Person To Contact In Case of Emergency
Please enter a valid phone number.
Format: (000) 000-0000.
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Monthly Package
Full Day 5.00pm
Mid Day 3.00pm
Half Day 12pm (compulsory)
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Registration Fee: RM100 Pay to: Tadika Suluh Sinar Bank Islam: 02084010040525 Please Attached Proof Of Payment
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Please verify that you are human
*
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Submit
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