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    MEMBERSHIP REGISTRATION FORM

    Instructions: Please complete the following form using CAPITAL!

 

1.

 

Name

 

:

 

2.

 

Place and Date of Birth

 

:

 

3.

 

Age

 

:

 

4.

 

Gender






 

 

5.

 

Address

 

:

 

6.

 

Class

 

:

 

7.

 

Phone number

 

:

 

8.

 

e-Mail

 

:

 

9.

 

Hobby

 

:

 

10.

 

Reasons of Membership

 

:

Sign here!

(Nama Lengkap)

 

NNote: write your full name please! (…………………………………………..)

Lengkapi Form di atas berdasarkan dialog di bawah ini!

Dayu               : Good Morning.

Syahputri         : Good Morning. May I help you?

Dayu               : Yes! I want to join our school English Club.

Syaputri           : Allright! First, I want to ask you some personal information in order to fulfill the registration form!

Dayu               : Okay!

Syahputri         : Could you tell me your full name please?

Dayu               : My name is Dayu Wahyu Pradnyan.

Syahputri         : What is your place and date of birth?

Dayu               : Banjar, I was born on April 25th , 2001.

Syahputri         : How old are you?

Dayu               : I am fifteen years old now

Syahputri         : Where do you live?

Dayu               : I live in Banjar Village.

Syahputri         : What is your class?

Dayu               : Natural science tenth one

Syahputri         : May I know Your phone number please?

Dayu               : 081999236675

Syahputri         : What is your e-mail address?

Dayu               : dayuwahyu12@gmail.com

Syahputri         : What are your hobbies?

Dayu               : I like reading a novel, watching Hollywood movies and listening to English song.

Syahputri         : Very good! Anyway, Why do you want to join our club?

Dayu               : Because I want to practice my English and I want to study in the United Kingdom.

Syahputri         : Interesting! The last, would you sign here please!

Dayu               : Yes!

Syahputri         : Welcome to the English Club. The activity will be held every Sunday except holiday in room 15 at 8’o clock.

Dayu               : Thanks for letting me to join the club.

Syahputri         : You are welcome. 

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