课程报名与体验课预约 | 槟城 Little Play Space

Student's Name

Gender

Male

Female

Day of Birthday

Birth Cert No / IC No

Please select the class that you interested, you may choose more than 1 option

Kindermusik - Foundations

Kindermusik - Level 2

Kindermusik - Level 3

Kindermusik - Level 4

Kindermusik - Level 5

Piano - Kids

Piano - 13 - 18 years old

Piano - Adult

Piano - Transferred

Kids Creative Drama (6 - 9 years old)

Kids Creative Drama (10 - 12 years old)

Ukulele / Bass / Guitar Sing-Along

AGORA Thinking and Expression - Preparatory (4 - 6 years old)

AGORA Thinking and Expression Level 1 (7 - 9 years old)

AGORA Thinking and Expression Level 2 (10 - 12 years old)

AGORA Thinking and Expression Level 3 (13 - 16 years old)

Guardian 1 / Mother's Name

Guardian 1 / Mother's Chinese Name

Guardian 1 / Mother's Mobile

Guardian 1 / Mother's Email

Guardian 1 / Mother's IC No

Guardian 1 / Mother's Occupation

Guardian 2 / Father's Name

Guardian 2 / Father's Chinese Name

Guardian 2 / Father's Mobile

Guardian 2 / Father's Email

Guardian 2 / Father's IC No

Guardian 2 / Father's Occupation

Address Line 1

Address Line 2

City

State

Postcode

Country

Home Contact Number

Preferred Language

English

Mandarin

Preferred Contact Method

Email

Remarks

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