Licensee Assessment Form

Full Name: *
Email: *
Contact Number:
(HP)*
Highest Academic Qualification: *
Proposed Locations (subject to availability):*
1)
2)
Proposed Commencement Date / Year: *
Captcha: *

I am / We are interested in the MY-ROBOT Licensing Programme and would be pleased if MY-ROBOT S/B could kindly take note of my / our interest to set up MY-ROBOT Learning Centre in the locations indicated
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