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Application for ELLIS Placement Test

Student Information

First Name:	Last Name:
Birth Date: // Month / Date / Year	Native Language:
Gender: Male Female
TOEFL Score (if tested):
Enrollment Date: // Month / Date / Year	Finish Date: // Month / Date / Year
Class: Ellis Basics Ellis Intro Ellis Middle Mastery Ellis Senior Mastery Ellis Master Pronunciation Ellis Business Series

Contact Details and Preferences

Mailing Address: Office Home
Company Address:	Home Address:
Business Phone:	Mobile Phone:
Fax:
Email:
Please re-enter your email address:

Day/Time Preference:

WEEKDAY SCHEDULE

The computer lab is available to the public Monday-Saturday 08:00 to 18:00, Sunday 08:00 to 16:00.

Requested Test Date:

Please arrange payment of Baht 500 (administrative fee) to:
Sasin Account 038-2-04022-1 at Siam Commercial Bank (Siam Square branch) via:

electronic bank transfer
check (payable to "Sasin")
cash deposit

An email confirmation of your test appointment will be sent after the Registration Form and Pay-in slip showing your complete name have been faxed to "ELLIS" 0 2216 1312

Dowload Application Form (PDF)

Applying to Sasin

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