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*Name of Student：

Last First

Sex：

F M

*Date of Birth：

　Day: Month: Year:

*Parent's Name：

Last First

Home Address：

Postal：

*Email Address：

Telephone：

*Home Office

*Mobile：

Preferred program：
English Mandarin Both

Nursery/Kindergarten/Primary Program：

Preferred Time：

Level：

Term/Holiday Program：

Preferred Day：

How do you know about HESS?

Friends

DM

Newspaper

Bus Advertisement

Flyer:

Media

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Would you like to be informed about upcoming Open Houses?

Would you like to further discuss the programs offered at HESS with the HESS Education Centre Manager?

Any other comments:

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