Name* |
|
Age* |
|
Sex* |
|
Address* |
Flat & Floor |
Building / Block no. |
Estate / Street |
District |
|
Tel no.* (Please provide at least one contact no.) |
mobile phone / pager no. |
home |
office |
Fax no. |
|
Email |
|
Name of School/Organisation |
(for school programme or Social Harmony Project only) |
Name of Programme* |
|
Date of Programme* |
Day Month Year (if the programme lasts for more than one
day, please enter the first day of the programme) |
Time* |
|
Programme Group |
(if
applicable) |
Total no. of Participants |
(for family, school programme or Social Harmony Project only) |
MuseKids no. |
(if applicable) |
Parent / Guardian (Applicable to
applicants under the age of 18) |
Name* |
|
Tel no.* |
|
Relationship to the child* |
|
*I
hereby certify that all the information provided is correct and complete. |
|
(*Field required) |
|