A-2-7 NZX Community Centre

PJU 1A/41B
Ara Jaya, 47301
Petaling Jaya, Selangor
TEL: 016-3124854 EMAIL: littlemillenniumresurces@gmail.com

Borang Pendaftaran /Admission Form

Name:
Year/Form:
Address:

Telephone Number:
School Name/Address:

IC Number/ Birth Certificate Number:

Guardian/Parent Name:
Occupation:
Emergency Contact Number:
Registration Fee:
A non-refundable registration fee of RM20 is charged for all children who wish
to attend Little Millennium Tuition prior to the monthly fee. This registration
fee does not guarantee you a place, and should we have insufficient availability,
the fee shall be fully refunded. If you choose to defer your childs placement,
or withdraw your application, this fee remains non-refundable. Cheques should
be made payable to Little Millennium Resources.

Signature:
Date: