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Home
About
Our Services
Programs Offered
Follow Us
Enrollment
Contact
Book A Meeting
Enrollment Form
Personal Information
Full Name
Date of Birth
Gender
City
Home Address
State/ County
Zip Code
Phone Number
Email
Marital Status
Program applying for
Site/ Location
Occupation
Education Level
Sponsor
Previous School if any
Academic Interests
Language Spoken at Home
Section A: Mon-Wed-Fri (7:30AM-12:30PM)
Section B: Mon-Wed-Fri (1:00PM-5:00PM)
Section C: Tue-Thur-Sat (7:30AM-12:30PM)
Section D: Tue-Thur-Sat (1:00PM-5:00PM)
Waiting List Option (if programs are full)
Yes
No
Interested Program
Send
Parent/Guardian Information
Full Name
Relationship to Student
Phone Number
Email Address
Address
Send
Emergency Contact Information
Name
Phone Number
Address
Relationship to Student
Send
Medical and Health Information
Medical Conditions
Allergies
Any Glasses?
Medications
Special Needs (if any)
Send
Payment and Financial Information
Payment Method / Installment
Source of Income
Frequency of Payments
Financial Assistance Required?
Yes
No
Payment Terms: 50% of Tuition is Required before starting each program
Signature
Date
Send
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