Center *: Phu Nhuan:Phu My Hung: Child’s Name *:
Email *: Phone Number *: Programs *: EnglishEnglish SparksHappy TalkPlay MathMath
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Center *: Phu Nhuan:Phu My Hung:
STUDENT'S NAME:
AGE:
DATE OF BIRTH:
GRADE:
SCHOOL:
GUARDIAN IN CHARGE:
RELATIONSHIP:
Phone Number:
RESIDENTIAL AREA(DISTRICT):
EMAIL ADDRESS:
AVAILABLE CONTACT TIME VIA PHONE:
AVAILABLE TIME TO VISIT THE CENTER
TIME:
DATE:
SUBJECTS INTERESTED TO ENROLL:
REASONS FOR APPLYING AT EYE LEVEL: (Please check all that applies.) I would like my child to cultivate a good discipline and good learning habits.I would like my child improve his/her academic performance at school.I would like to arouse my child's interest in learning.Others, please specify:
MORE INFORMATION ABOUT STUDENT: His/her interest in learning is: HighAverageLow
What time does he/she finish school in the week?
MON:
TUE:
WED:
THUR:
FRI:
SAT:
SUN:
Does he/she have an after-school tutorial: Yes
Name of the tutorial center:
Tutorial Days & Times:
No
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Email *: Số Điện Thoại *: Khóa Học *: EnglishPhát Âm Chuẩn Eye LevelHappy Talk'Chơi' với ToánToán và Toán Tư Duy Khóa Học Online *: Tiếng AnhToán Câu Hỏi hoặc Bình Luận: