Christmas 2018 Registration Form

Christmas 2018 – Enrollment Form

Please complete a separate form for each child. Enrollment will be confirmed via email only when both this enrollment form and full tuition payment have been received. Enrollment is not guaranteed if we do not receive your payment within 5 business days of receiving this form. Payments can be made by crossed check payable to "Baker and Bloom Limited".

For enquiries, please email info@bakerandbloom.com.
Student Information
Student's Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Grade (2018-2019)
School
Student E-mail (if any)
Student's Contact No. (if any)
Format: 00000000.
Home Address

Floor, Block, Building, Estate

Street Name

DistrictCity

Attn:Country
Remarks
Has the student attended Baker & Bloom before?
Please select the sessions he/she has attended.
Parent Information
Parent's Name

First NameLast Name
Relationship to Student
Parent's Contact No.
Format: 00000000.
Parent's Email

Confirmation Email
Is this parent the primary emergency contact?
Emergency Contact Name

First NameLast Name
Relationship to Student
Emergency Contact No.
Format: 00000000.
How did you hear about Baker & Bloom?

Other
Full name of person who referred you to Baker & Bloom:
Course Selection
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Age 4-5 inspirED Reader & Writer: How The Grinch Saved Christmas2,000 HKD

Time Slot
Item subtotal:0.00 HKD

Age 4-5 Public Speaking800 HKD

Time Slot

Age 6-7 inspirED Reader & Writer: The Polar Express4,500 HKD

Time Slot
Item subtotal:0.00 HKD

Age 6-7 Creative Writing4,500 HKD

Time Slot

Age 6-7 Public Speaking4,500 HKD

Time Slot
Item subtotal:0.00 HKD

Age 8-9 inspirED Reader & Writer: Christmas Around the World4,500 HKD

Time Slot
Item subtotal:0.00 HKD

Age 8-9 Creative Writing4,500 HKD

Time Slot

Age 8-9 Public Speaking4,500 HKD

Time Slot
Item subtotal:0.00 HKD

Age 8-9 Super Learner1,800 HKD

Time Slot

Age 9-11 Super Learner2,700 HKD

Time Slot

Age 10-11 Public Speaking4,500 HKD

Time Slot

Age 10-11 Super Learner4,500 HKD

Time Slot

Age 11-13 Boarding School Essay Workshop5,000 HKD

Time Slot
Item subtotal:0.00 HKD

Age 12-18 Media Literacy in partnership with The New York Times6,000 HKD

Time Slot
Item subtotal:0.00 HKD

Age 13-15 Essentials of Essay Writing6,000 HKD

Time Slot
Item subtotal:0.00 HKD

Age 14-15 IGCSE English3,600 HKD

Time Slot

Age 16-18 IBDP English3,600 HKD

Time Slot

Age 16-18 College Essay Clinic6,000 HKD

Time Slot

Total 0.00 HKD
Tuition (HKD)
Payment Method
Check or Bank Transaction Number
Parent Name
Parent Signature
Date

DayMonthYear
Should be Empty:

Student Information

Parent Information

Course Selection

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Select Your Course(s)