Registration

Registration for Stanford EPGY Honors Academies: June 18 - 29

Student's Details

Student's Name *

First

Last

Name to appear on certificate *

Date of Birth (dd/mm/yyyy) *

Gender *

Male Female

Vegetarian? *

Yes No

Email *

Telephone *

School *

Grade Level *

Course *

Upload School Report *

Max file size: 20MB

Parent's Name *

First

Last

Email *

Telephone *

Address *

Line 1

Line 2

City

State

Zip Code

Country

How did you hear about this program? *

Applications will only be processed once full supporting documents and a valid cheque are received
Course fee is S$1,650
Cheques must be made out to "V-Campus Pte Ltd" and mailed to the following address:

V-Campus Pte Ltd
79 Robinson Road
#25-02, CPF Building
Singapore 068897

Cheques will not be banked in until after applicants have been accepted for a course and they have received confirmation that the course will proceed.
V-Campus reserves the right to cancel any class due to insufficient registrations
Withdrawals less than 8 weeks prior to the start of the Honors Academies will not be eligible for refund

Closing date for applications is 9 April 2012

I agree to the Terms & Conditions listed above

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