Junior English Holiday Program Application Form

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Step 1 of 2

Parent / Guardian Details

Parent / Guardian Name
Email

Address

Home Address
Hotel Address in Malaysia (OPTIONAL)

Child Details

You can add more than one child. Click + button to add more

Start Date & Duration

Choose Start Date

Health Declaration

Your children's health conditions (if any)

Passport ID Pages

Click or drag files to this area to upload. You can upload up to 10 files.
Please upload the ID page of your child's passports. You may upload multiple files if more than one.