ThinK & STUDY SMART - REGISTRATION FORM

REGISTRATION FORM

AOL
REGISTRATION FORM

Name

Address

Postcode

Tel: (House)

Age

Sex

Primary/Form/Level

School/Institution

Father's/Mother's Name

Occupation

Company's Name

Address

Tel: (office)

E-mail Address (Parent)

E-mail Address (Child/Student)

I hereby allow my child (named above) to participate in the
AOL Workshop marked below and enclose
my payment of RM .
Cash/Cheque No. issue to LAWRENCE WALTER SEMINARS.

N.B. Please attach your business card for our reference.

N.B. ALL FEES PAID ARE NOT REFUNDABLE BUT ARE TRANSFERABLE TO ANOTHER COURSE
(WITHIN 6 MONTHS)

If deposit is made, balance payment must be settled at least 4 weeks before the commencement of the course to confirm your place.

Please select and indicate your choice

CODE (9-12 YRS.OLD):____________________

CODE (Form 1-6 ):________________________

CODE OTHERS:_________________________

Signature of Parent/Participant

( Signature / Date )

Note: Pls. print this copy and mail to us together with your cheque or
Email to notify us and mail. payment to our corporate office:
AOL Fax No: 03- 21452760 E-mail: lwdirect@lwseminars.com

FOR OFFICE USE

A. RECEIPT NO :_____________ B. AMOUNT : ________________ C. ISSUED BY : _____________ D. BALANCE AMOUNT : ________ E. RECEIPT NO : ____________ F. REMARKS : _______________