Enrollment Form for WMI Programs

WMI Education | www.WMI-Education.com | www.facebook.com/wmi.education
Unit 903, Park Commercial Building, 180 Tung Lo Wan Road, Hong Kong
Tel: +852 2325 9000 | Fax: +852 2325 9019 | info@wmi-education.com
www.WMI-Education.com
Enrollment Form for WMI Programs
Enrolment is first come first served. Due to limited spaces, spots will only be secured when full payment is received.
Personal Information *
Student’s Name:
學生姓名:
Date of Birth: (dd/mm/yy)
Gender: (M/F)
Native Language(s):
Home Tel:
Parent’s Name #:
Email:
Mobile:
Emergency Contact:
Relationship:
Mobile:
Address:
Health/ Medical/ Allergy issue(s):
* All fields above are required. # The accompanying adult in the playgroup courses, if applicable.
Course
☐ Crawlers (6 – 12 Mths)
Preferred Days ^
☐ Mon ☐ Tue ☐ Wed ☐ Thu
Time Sessions ^
☐ Morning
No. of Lessons +
☐ 10
☐ Walkers (12 – 18 Mths)
☐ Fri ☐ Sat ☐ Flexible
☐ Afternoon
☐ 20
☐ Talkers (18 – 24 Mths)
☐ Flexible
☐ Thinkers (24 – 36 Mths)
☐ Toddlers Phonics (3 – 4 Yrs)
☐ Mon ☐ Tue ☐ Wed ☐ Thu
☐ Morning
☐ 16
☐ Phonics (5 – 6 Yrs)
☐ Fri ☐ Sat ☐ Flexible
☐ Afternoon
☐ 20
☐ Flexible
TOTAL (HK$)
^ Your choices indicate your preference which we will try our best to accommodate; however, we are unable to
guarantee till our confirmation. + Please refer to course descriptions for duration of each lesson.
I have read and agreed to the terms and conditions printed at the back of the page.
Parent’s Name: ___________________ Parent’s Signature: __________________ Date: ______________________
Handled by: _____________________ Payment: ☐ Cash ☐ Bank Transfer ☐ Cheque
www.WMI-Education.com
www.facebook.com/wmi.education