Student Registration Form

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STUDENT REGISTRATION FORM

FULL NAME: ADDRESS: PARENT'S NAME CONTACT NO: / DATE OF BIRTH: Have you attended any Mathematic Courses? If Yes: Course Name Yes / No Level of Completion: E-MAIL ADDRESS:

CLASS DETAILS
Venue: SRJK Simpang Lima, Jalan Langat, Taman Sri Andalas, 41200 Klang, Selangor

Package Details
Please (/) in the appropriate class category

Std 1 - 3

Std 4 - 6

Form 1 - 3

Speed Math Junior 1 - 3 months Speed Math Junior 2 - 3 months Bar Model Junior 1 - 3 months Bar Model Junior 2 - 3 months Olympiad Math Junior 1 - 3 months Olympiad Math Junior 2 - 3 months

Speed Math 1 - 3 months Speed Math 2 - 3 months Bar Model 1 - 3 months Bar Model 2 - 3 months Olympiad Math Elementary 1 - 3 months Olympiad Math Elementary 2 - 3 months

Speed Math 1 - 3 months Speed Math 2 - 3 months Olympiad Math Elementary 1 - 3 months Olympiad Math Elementary 2 - 3 months Olympiad Math Expert 1 - 3 months Olympiad Math Expert 2 - 3 months

Terms & Condition


1. 2. 3.

Monthly fee for all levels are RM 120. Material fee is RM 30. Monthly fee is payable upon first date of class. I agree with the above Terms & Condition
________________ Parent's signature ________________ Date

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