Application Form

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1. Login Info

E-mail Address

*In case you enter the e-mail address of your cell phone, please specify the domain to “gsacademy.com".

Password

Please enter a minimum of 6 characters

2. Student Details

First Name

Last Name

Date of Birth

*Minimum age requirement: 4+

Sex

Address

City

State/Province/Region

Postal Code / ZIP Code

Telephone Number

Allergies

Past Illnesses

Please tell us about your child’s English learning experience.

Your child has never studied English, has little to no English exposure, and requires translation to understand English.
Your child can understand English if spoken at a slow rate with some repetition, and responds in English but needs time to how to express thoughts.
Your child can understand most of what is said at a normal rate of speech and, despite some errors, can communicate thoughts well in English.
Your child is a native English speaker, lives with English speakers, and/or has studied English for many years. Your child can communicate fluently in English for his/her age level.

Interest

Family Members

Parent/Guardian A Name

Parent/Guardian A Phone Number

Parent/Guardian A Email

Parent/Guardian B Name

Parent/Guardian B Phone Number

Parent/Guardian B Email

Emergency Contact Information

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