December Junior Robotics Workshop Please fill in the registration form. We will get back to you within 1 day (including weekend). :-)
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? *	Yes   No   Keep me updated in other medium:
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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