Section 1 of 6
Student Registration Form
Hi
This form is automatically collecting emails from all respondents.Change settings
*,3sz*, ,Good Morning
*,3sz*, ,Good Morning
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Section 2 of 6
1. PERSONAL DETAILS
Carys Webster
Andrew
Andrew
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Wanjohi
Wanjohi
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
10/10/2003
10/10/2003
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Question
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Question
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Nationality - Kenyan
Nationality - Kenyan
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Mombasa
Mombasa
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Question
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Section 3 of 6
9am-12:30pm
French
A1 - Beginner intensive 48 hours per mounth
A1 - Beginner intensive 48 hours per mounth
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Option 2
Add option
or
add "Other"
…
Answer key
(0 points)
Loading...
Morning Intensive _ Mondays to Thursdays_9.30 am to 12.30 pm
Morning Intensive _ Mondays to Thursdays_9.30 am to 12.30 pm
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Option 2
Add option
or
add "Other"
…
Answer key
(0 points)
Loading...
no
no
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
1.
No
2.
Add option
…
Answer key
(0 points)
Loading...
Section 4 of 6
RULES & REGULATION
Kindly tick the here-below boxes to certify, to the best of your knowledge, that all the information you have provided herein is true and correct and that you have read, agreed to be bound by the rules and regulations of Alliance Française de Mombasa.
Kindly tick the here-below boxes to certify, to the best of your knowledge, that all the information you have provided herein is true and correct and that you have read, agreed to be bound by the rules and regulations of Alliance Française de Mombasa.
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
All fees shall be paid during registration.
No refunds or credits will be made for discontinued or interrupted attendances of the course by the student
Alliance Française de Mombasa, while committed to providing a safe environment, does not accept liability for loss of property or personal injury.
Add option
or
add "Other"
…
Answer key
(0 points)
Loading...
Section 5 of 6
PAYMENT INFORMATION
Please indicate the payment details below
Account No. YOUR NAME and CLASS
(Eg: John A1)
AMOUNT PAID:
AMOUNT PAID:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(5 points)
Loading...
PAYMENT REFERENCE [MPESA N°/BANK DETAILS]
PAYMENT REFERENCE [MPESA N°/BANK DETAILS]
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Correct answer: Correct answer
Answer key
(0 points)
Loading...
Section 6 of 6
Untitled Sectionthanks
thanks
Question
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Option 1
Add option
or
add "Other"
…
Answer key
(0 points)
Loading...
Link to Sheets
Summary
Question
Individual
Insights
Total points distribution
Loading...
Settings
Release grades
Respondent settings
Global quiz defaults
Default question point value
Point values for every new question
Responses
Manage how responses are collected and protected
Presentation
Manage how the form and responses are presented
Defaults
Form defaults
Settings applied to this form and new forms
Question defaults
Settings applied to all new questions