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Small Group Lesson interest form
First name
Last name
Birthday
Gender
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Female
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Email
Country Code
Phone
Is the phone number above connected to WhatsApp?
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Yes
No
Are you currently in Penang?
*
Yes
No
English Level
*
Beginner
Pre-Intermediate
Intermediate
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When are you hoping to start studying English?
*
As soon as possible
Within 1 month
More than 1 month from now
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