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Booking for School Visit
Please fill in information below for booking the school visit
បំពេញព័ត៌មានខាងក្រោមសម្រាប់កក់ការធ្វើតេស្តចូលរៀន
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Student's Full Name in English ឈ្មោះសិស្សសរសេរជាភាសាអង់គ្លេស
*
Your answer
Student's Full Name in Khmer ឈ្មោះសិស្សសរសេរជាភាសាខ្មែរ
*
Your answer
Sex ភេទ
*
Female ស្រី
Male ប្រុស
Date of Birth ថ្ងៃ ខែ ឆ្នាំកំណើត
*
MM
/
DD
/
YYYY
Booking Date for School Visit កក់ថ្ងៃសម្រាប់មកមើលសាលា
*
MM
/
DD
/
YYYY
Booking Time ម៉ោងសម្រាប់មកមើលសាលា
Time
:
AM
PM
Name of Person who facilitates the school visit ឈ្មោះអ្នកនាំសិស្សមកមើលសាលា
*
Your answer
Connection to the student ត្រូវជាអ្វីនឹងសិស្ស?
*
Parents ប៉ាម៉ាក់
Relative សាច់ញាតិ
Other:
Required
Mobile #1 លេខទូរស័ព្ទទំនាក់ទំនង ទី១
*
Your answer
Mobile #2 លេខទូរស័ព្ទទំនាក់ទំនង ទី២
Your answer
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