December Junior Robotics Workshop

Name of Student *
BC Number *
Date of Birth

DD
/
MM
/
YYYY
Sex *
 Male 
 Female 
School
Class in School (e.g. 6A)
E-mail *
Address *
Postal Code
Telephone Number *
Remarks pertaining to:
Medical Condition (if any)
Behavioural Issue (if any)

Parent's/ Guardian's Particulars

Name *
Relationship to Student *
 Father 
 Mother 
 Guardian 
Contact Number *
Other Contact Number
E-mail *
Please indicate preferred mode of contact *
 E-mail 
 Mobile Phone 

Quick Queries

Please answer the following questions.
Do you want to be in our e-mai list for our future courses in Robotics? *
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Date and Timing

All sessions are 4 hours long. Please select your preferable date and timing . Take note that the course fees include the Robotics set.
Date and Timing *
 26 Nov (Sat) 
 27 Nov (Sun) 
 10 Dec (Sat) 
 11 Dec (Sun) 
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