Student Registration Form

Please fill in your particulars below. We will contact you as soon as we find a suitable assignment for you. * denotes a compulsory field.

Personal Particulars
* Parent/ Guardian's Salutation

* Parent/ Guardian's First Name

* Parent/ Guardian's Last Name

* English Speaking		Yes No

* Student's First Name

* Student's Last Name

* Student's NRIC

* Student's Age

* Student's Gender		Male Female

* Student's Race

If others, please state

* School (Enter 'NIL' for none)

* Level

If others, please give details

* Parent/ Guardian's Mailing Address

* Postal Code SINGAPORE

Student's Address (please ignore if same as above)

Postal Code SINGAPORE

Parent/ Guardian's Office Phone

* Parent/ Guardian's Home Phone

Parent/ Guardian's Mobile Phone

Mobile Phone Provider if applicable

If others, please state

Parent/ Guardian's Pager

* Parent/ Guardian's Email Address		(Enter 'NIL' for none)

* Preferred mode of communication

* Student's Date of Birth Day		Month Year



*Tuition Details*

* Subjects requiring tutoring

* Preferred Days and Timing (You can check more than one box) Morning Afternoon Evening

		Mon

		Tue

		Wed

		Thu

		Fri

		Sat

		Sun

* Preferred Frequency every week

* Preferred Duration each session		hours minutes

* Preferred price (Select 1 only)		No preference

		Hourly rate of

		Monthly rate of

What else do we need to know?
(E.g. Gender/ Race/Qualifications of tutor required)

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Please press the submit button and your registration will be processed. Thank you!