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ONLINE REGISTRATION FORM

WHO AM I?* NEW STUDENTRETURNING STUDENTEXTEND MY STUDYAGENT

STUDENT'S DETAILS

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Phone*

Nationality on Passport*

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Which VISA you will be travelling with? *

Current Language Ability *

AGENT'S DETAILS

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Agent Full Name

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Direct Phone Number

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Course 1

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SEOUL, GangnamSEOUL, HongdaeBUSAN, Seomyeon

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Start date* (You can start your course on Monday only)

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Arrival Services

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Course 2

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Not requiredSEOUL, GangnamSEOUL, HongdaeBUSAN, Seomyeon

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Message *

agree I hereby confirm that my payment of the fees as invoiced, in conjunction with my signing of this form, constitutes my acceptance of the terms of my agreement with Lexis Korea in relation to my enrollment. I have read and agree to be bound by all of the Conditions of Enrollment