ENGLISH AVENUE

Into a new Avenue of Better Learning and Discovery

ENROLLMENT FORM
Parent/Legal Guardian Mr. Mrs. Miss
Spouse
Address
City/ State/ Postal Code
Email
Home Phone (
-

Work Phone (

Mobile Phone no.: Mothers (

) Fathers (
What are your reasons opting for this programme for your child?

)
-

1. because I intend to send my child to study in an English-speaking country later

2. to obtain an education in English
3. social problem at previous school
4. unable to cope in the conventional school system
5. others
_____________________________________________________________________________________
Do you intend to prepare your child for the Cambridge IGCSE Olevels Examinations?

Yes

No

What does your child do for sports?

What does your child do for music and art?
Do you have a religion? If Yes, please state ____________________________________________

Payment and cancellation policy

If you choose to cancel after enrolling with English Avenue, please call our administrative office promptly.
If you have already submitted the completed placement test, a fee on the test will be charged to you.
Tuition fee will be billed at the beginning of each school term, there are 3 terms in a year.
If you wish to terminate, please inform us with a written notification 1 month before your termination, otherwise
a 1 month fee is chargeable to you

Parent/Legal Guardian Signature

Date

STUDENT INFORMATION
Students Legal Name
First MI Last

Gender M F
Date of Birth / / Age
Information on your previous school
1. chinese public school
ENGLISH AVENUE | B-13A-3, Jalan C180/1, Dataran C180, 43200 Cheras, Selangor
Mobile : 012-327-6854

Into a new Avenue of Better Learning and Discovery

ENGLISH AVENUE

2. public school
3. private school
4. homeschooling
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Students
strength

___________________________________________________
_
Students

weakness

___________________________________________________
Student has any medical history?
If yes, please state

Yes

No

_______________________________________________________________________________
_______________
Students
last
visit
to
an
eye-examination
_________________________________________________
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Other Requests
1. Uniform order
Number of pieces required :
Measurement :

For office use

Accepted in Grade Level (1. Challenger 2. Super Challenger 3. Intensive
Date of start: __________________________________

4. Advance)

Diagnostic Test taken on ___________________________

Test Point : English ________________ Mathematics _______________
Comments :
Referred by who
_____________________________________

ENGLISH AVENUE | B-13A-3, Jalan C180/1, Dataran C180, 43200 Cheras, Selangor
Mobile : 012-327-6854