International House Saudi Arabia

REGISTRATION FORM FOR YOUNG LEARNERS

Student Name (English)

Student Name (Arabic)

Date of Birth

Gender

Male
Female
Prefer not to say

Parent / Guardian Name (English)

Custom If No

Parent / Guardian Name (Arabic)

Relationship to Student

Mobile No

Home Address

Address Line 1

City

State / Province / Region

Country

Has the student studied English before?

If yes, where?

Consent

I confirm that the information provided is correct and give permission for my child to participate in the English learning program now or in the future.

Parent/Guardian Full Name

Date

Custom Captcha