Two-Month Intermediate Conversation Course Course Registration Form
Welcome and thank you for choosing to register for our Two-Month Intermediate Conversation Course taught partially by a native speaker! We are excited to help you develop your English conversation skills and enhance your language proficiency. In order to be admitted and secure your spot in the course, please complete the form below with your personal information and preferences. We look forward to having you join our community of language learners!

Full Name*

Full Name*

E-Mail*

E-Mail*

Whatsapp Number*

Whatsapp Number*

Which country are you from?*

Which country are you from?*

Highest Education*

Highest Education*

Your current English level.
If you don’t know your level kindly check your level here:
https://englishnow.co.id/placement-test/*

Your current English level.
If you don’t know your level kindly check your level here:
https://englishnow.co.id/placement-test/*

Tick the following statements that are true to you.*

Tick the following statements that are true to you.*

What do you need English for in your real-life situations?*

What do you need English for in your real-life situations?*

Choose at least three topics that really interest you.*

Choose at least three topics that really interest you.*

Your preference for language focus

Your preference for language focus

Your preference for language skill to develop

Your preference for language skill to develop

Other notes? Hopes/expectations for this course? (if any)

Other notes? Hopes/expectations for this course? (if any)

Payment Confirmation

Please Complete your payment

Please Complete your payment

Conversation Class

1st Month= Rp. 350.000,-

Full COurse= Rp. 700.000,-

 

Payment done via transfer to

Bank Muamalat

1010125851

Yayasan Cerdas Taqwa Kreatif

Upload your payment receipt here*

Upload your payment receipt here*

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