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Formulir Pendaftaran LKP Global Lingua Brebes
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* Indicates required question
Full Name
*
Ketikkan nama lengkap Anda menggunakan huruf kapital. Contoh: LEKSITO RINI
Your answer
Placa and Date of Birth
*
Ketikkan tempat dan tanggal lahir Anda. Contoh: Jakarta and 16 March 1979
Your answer
Address
*
Ketikkan alamat rumah Anda. Contoh: Jalan M.T. Haryono No. 15 Saditan - Brebes
Your answer
Telephone Number / Mobile Number
*
Ketikkan nomor telepon / HP Anda
Your answer
Parent's Name
*
Ketikkan nama orang tua Anda
Your answer
Parent's Occupation
*
Ketikkan pekerjaan orang tua Anda
Your answer
Educational Background
*
Pilih latar belakang pendidikan Anda.
Play Group (KB)
Kindergarten (TK)
Elementary School (SD)
Junior High School (SLTP)
Senior High School (SLTA)
Bachelor Degree (D-IV/S-1)
Master Degree (S2)
Doctoral Degree (S3)
Required
Grade / Semester
*
Tulis kelas atau semester Anda
Your answer
Course you choose is:
*
Pilih jenis kursus
EFK (English For Kids)
EFT (English For Teenagers)
EAC (English for Active Communication)
EJH (English for Job Hunting)
Translation Service
Preparation to TOEIC/TOEFL Class
CFK (Computer For Kids)
Required
Alternative Course Day
*
Ketikkan alternatif hari belajar dalam 1 (satu) minggu
Your answer
Alternative Course Time
*
Ketikkan alternatif waktu belajar dalam 1 (satu) minggu
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