2015 Summer Camp Registration Form                                                                      
Contact Number (聯繫方式）: 604-633-0658 / 778-237-2195
Email （郵件）： info@futureleader.ca
Address （地址）： 970 Burrard Street， Apt 230， Vancouver, BC, V6Z2R4

Fee Information:(Flight tickets excluded)
2 Weeks: $999
3 Weeks: $1399  
Registration Deadline: June 20th
       
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Name 姓名 *
Gender 性別 *
Birth Date 出生日期 *
MM
/
DD
/
YYYY
Address 家庭住址 *
Phone 電話 *
Email 郵箱 *
Emergency Contact Name 緊急聯繫人 *
Emergency Contact Number 緊急聯繫電話 *
Weeks of Camp
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Payment Methods 付款方式 *
(1) Cheque Payable to:  Hanyin Education Consulting Inc. (2) Pay invoice from Hanyin Education Consulting Inc. via Paypal  (3) Pay cash in DT office
How do you know us? 你是如何知道我們的？ *
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