Downloads
Course Guide : August, September, October 2010/PDF Summer Camp 2010/PDF April, May, and June 2010/PDF
Membership Form : MS Word/PDF
Jl. Kemang Dalam X No. E6A South Jakarta, 12730 p. +62 21 7179 2813 | +62 21 719 22 16 f. +62 21 719 22 16 e. jicc@cbn.net.id / jicc_online@yahoo.com
Play Center > Play Center Form
Play Center Schedule Play Center Form
Jakarta International Play Center Age Group 2 - 4 1/2 years
PRE - REGISTRATION FORM
Student's surename
: ________________________________________
Student's first name
Date of Birth
d : _______ m : _______ y : _______
Title
: Mr. Ms. Dr. (Please Circle)
Parent's name
Address
Home phone
Handphone No.
Office No.
Emergency Contact
Name
: _______________________
Home No
Handphone No
Office
I / we hereby confirm that my son / daughter is to be enrolled in the Jakarta International Play Center.
________________________
