STUDY AT TOP CANADIAN UNIVERSITY Spend your weekends with representative from overseas universities/colleges Please complete the following form to register the session! (Use your active Email and Whatsapp number to get the confirmation)! OK Question Title * 1. Personal Information Nama Murid | Student Name Nomor Handphone Murid| Student Handphone Number Alamat Email Murid| Student E-mail Nama Orang tua | Parents Name Nomor Handphone Orang tua | Parents Handphone Number Alamat E-mail Orang tua | Parents E-mail Alamat Rumah | Home Address OK Question Title * 2. Tempat Lahir | Place of Birth (Student) OK Question Title * 3. Tanggal Lahir | Date of Birth (Student) Date / Time Date OK Question Title * 4. Pendidikan | Education Universitas | University SMA | Senior High School SMP | Junior High School OK Question Title * 5. Detail Pendidikan | Student Education Detail Sekolah/Universitas School/University Kelas/Semester Grade/Semester OK Question Title * 6. Pernah Mengikuti Test | Test Taken TOEFL IELTS SAT GRE GMAT Baru Mendaftar OK Question Title * 7. Tingkat Pendidikan Tujuan | Program Interested High School Foundation / Diploma (Pathway) University Transfer Program (College) Bachelor Degree Post Graduate Diploma / Certificate Master Degree PhD OK Question Title * 8. Bidang studi yang ingin diambil | Major Interested OK Question Title * 9. Mengetahui acara ini dari | How do you know this event Social Media (Instagram, Facebook, Twitter) Website Family/Friends School Invitation (please write the name) OK DONE