Trial Lesson Registration Form

Trial Lesson Registration Form

Fill up the form and make payment before coming for a trial.
Student Name*

Full NameSurname
Gender*
Student's Mobile Number*

Phone Number
Student E-mail*
School/Level
Address*

Street Address

Street Address Line 2

CityState / Province

Postal Code
Parent's Name*

First NameSurname
Parent's Mobile Number*

Phone Number
Parent's Email*
example@example.com
Please indicate which trial class are you signing up for. We will contact you to make the arrangement if a trial lesson is available. If a trial lesson is not available, we will refund the fee in full.*

Sec 1 MathSec 2 MathSec 3 E MathSec 3 A MathSec 4 E MathSec 4 A MathSec 4 ChemistryJC1 H2 MathJC2 H2 Math1 to 1 ClassOther
Referred by:
Please indicate the parent or student's name.
How did you get to know us?*

Google SearchGoogle AdsFacebookFacebook AdsInstagramInstagram AdsYouTubeWalk-by our centresOther
Fee for trial lesson*
prevnext( X )
JC H2 Math Trial lesson$120.00SGD

Secondary-level Trial lesson$100.00SGD

1 to 1 Class$150.00SGD

Total $0.00SGD
Should be Empty: