Contact information AY 2024
Registration
Email *
Student's Name *
Student's mobile number *
School *
CCA (Specify if performing or A div sch rep)
Level *
Mailing Address *
Parents' name *
Parent's mobile number *
Parent's email (for e-receipt) *
Relationship to student *
Sec 3 Classes (AY 2024)
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Sec 4 Classes (AY 2024)
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JC 1 classes (AY 2024)
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JC 2 classes (AY 2024) 
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Mode of lesson (if hybrid class chosen) *
Date of first lesson *
MM
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DD
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YYYY
How did you come to know about Mr Khemistry? *
Grade of last major exam before joining *
O level Chemistry  *
Why did you choose Mr Khemistry? *
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