EXCELLENT LEARNING Pondok Tanah Mas Jl. Kenanga III D 23 No.14 Cibitung Nomor Telepon: 083877017433
FORMULIR PENDAFTARAN
Nama Lengkap : ....................................................................................................
Tempat, Tanggal Lahir : .................................................................................................... Alamat : .................................................................................................... Sekolah : .................................................................................................... Kelas : .................................................................................................... No. Hp : .................................................................................................... Pelajaran yang Disukai : .................................................................................................... Hobi : .................................................................................................... Cita-cita : .................................................................................................... Nama Bapak : .................................................................................................... Pekerjaan Bapak : .................................................................................................... No. Hp Bapak : .................................................................................................... Nama Ibu : .................................................................................................... Pekerjaan Ibu : .................................................................................................... No. Hp Ibu : .................................................................................................... Dengan ini menyatakan bahwa mengizinkan / tidak mengizinkan anak tersebut untuk mengikuti kegiatan bimbingan belajar Excellent Learning. Bekasi,................................. Mengetahui Orang Tua Murid,
* Lampirkan Foto Copy Raport Terakhir
* Tindak lanjut akan mengundang bapak/ibu wali murid untuk membahas teknis serta jadwal pembelajaran. Contac Person: 083899702365 (Bimbel Excellent Learning)