Student Enrolment Form First Name *Last Name *Gender *FemaleMaleNationality *Date of Birth *MonthSelect month123456789101112DaySelect day12345678910111213141516171819202122232425262728293031YearSelect Year212621252124212321222121212021192118211721162115211421132112211121102109210821072106210521042103210221012100209920982097209620952094209320922091209020892088208720862085208420832082208120802079207820772076207520742073207220712070206920682067206620652064206320622061206020592058205720562055205420532052205120502049204820472046204520442043204220412040203920382037203620352034203320322031203020292028202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926Email Address *Course *General ESLESL 4 (4 man-to-man)IELTSLEAPNote: IELTS and LEAP is only available from 8/13/2023Dormitory *Premium Single Room APremium Single Room BStandard Single RoomSemi-Single RoomStandard Triple RoomCapsule Quad RoomStart Date *12-28-202501-11-202601-25-202602-08-202602-22-202603-08-202603-22-202604-05-202604-19-2026OTHER START DATEOther Start Date *Duration *1 week2 weeks3 weeks4 weeks8 weeks12 weeks16 weeks20 weeks24 weeksOTHER DURATIONOther Duration *Pick-up Service *GroupIndividualNoFlight Information (Group/Individual Pick-up Service)Your LINE/ WECHAT/ WHATSAPP/ KAKAOTALK account:Other information you want us to take note of:SubmitPlease do not fill in this field.
