Bridge Academy — Enrollment Form

1

Personal Details

Full Name Please enter your full name

Nickname optional

Phone Number Please enter your phone number

Date of Birth Please enter your date of birth

Email optional

2

Emergency Contact

Contact Name Please enter a contact name

Relationship Please select a relationship

Contact Phone Please enter a contact phone number

3

Program

Which program are you enrolling in?

Essential English

Stage 1 · A1–A2 · Beginner to Elementary

Fluent English

Stage 2 · A2–B1 · Pre-Intermediate to Intermediate

Intensive English

Stage 3 · B1–B2 · Upper-Intermediate to Advanced

Please select a program

Delivery Mode

🏫 Campus

💻 Online

Please select campus or online

Preferred Time Slot

10:00–11:30 AM

1:00–2:30 PM

3:00–4:30 PM

7:00–8:30 PM

Please select a preferred time slot

4

Payment Plan

How would you like to pay?

💳

Full Year

Both terms paid upfront — best value

📅

Per Term

Pay one term at a time

✂️

50 / 50 Split

Half now, half within 14 days

Please select a payment plan

By submitting, you confirm your interest in enrolling.
We'll be in touch within 1 business day. Questions? Message us on Telegram →

You're enrolled!