Form

General Enquiry

First name*

Student's first name 學生名字

Last name*

Student's last name 學生姓氏

Date of birth*

學生出生日期

School*

就讀學校

Grade*

年級

Class options*

課堂類型

1st contact name*

Parent's name 家長姓名/ 聯絡人姓名

Phone number (WhatsApp)*

聯絡電話 (WhatsApp)

Referral channel*

Referral friend's Name (if any)

推薦朋友名稱

Where have you learnt English elsewhere outside of school (learning centres etc) ?*

除了就讀的學校以外, 曾學過英語的教育中心名稱

Why Mud Pies? How do you think we can help your child?*

您希望我們如何幫助您的孩子？

Does your child have any Special Educational Needs and Disability (SEND)? Yes/ No
If Yes - pls provide details*

您的孩子是否有任何特殊教育需求和殘障（SEND）？是/否
如果是 - 請提供詳細資料