S.H.I.E.L.

D
Strategic Help In Essential Language Development

Joining Date : ______________ Course Duration: ______________

Language : ______________

Name :______________________________________________________________________________________________

Age :__________________ Gender :______________________

Contact No :__________________ Nationality :______________________

Address :______________________________________________________________________________________________
______________________________________________________________________________________________

Qualification :__________________ Mother Tongue :______________________

Occupation :__________________ Language Proficiency: _________________

Purpose for Learning:

o Job
o Education
o Business
o Visa Processing
o Natural Interest

**Note:
a)
Total course duration: 3 and ½ months.
b)
Total course hours: 42 to 45 hours per level.
c)
Course fees are non-refundable.
d)
Students must provide a picture and a photocopy of NID / Passport / Birth Certificate

_____________________________
Signature

Uttara Branch: House – 77, Road – 16,

Sector – 11, Uttara, Dhaka - 1230
Hotline: 01755-092760 / 01755-651597