2021 Summer Online Program 暑期線上課程
WALNUT CHINESE LANGUAGE CENTER
20850 CARREY RD. WALNUT, CA 91789
909-594-8880
Email *
Enrollment Type (select all that apply) *
Required
Number of Weeks 參加週數 *
Select the the weeks to attend 請在參加的週數打勾 *
Required
Student Name 姓名 (Chinese and English ) *
DOB 生日 *
Gender 性別 *
School 目前就讀學校 *
Grade 年級 on August/2021 *
If selected N/A, please state current school grade 目前就讀年級 (非1-6)
Chinese Proficiency 中文程度 *
Last completed Chinese textbook level 已讀完美洲或其他 ____ 第____冊 *
*
Native Language 母語 *
Required
Address 住址 *
Parent/Guardian Name 父母 / 監護人名字 *
Parent/Guardian's Relationship to Student 關係
Clear selection
Parent/Guardian's Phone Number (Home)
Parent/Guardian's Phone Number (Cell) *
Parent/Guardian's Email *
Family Doctor's Name and Telephone
Make Payment *
Required
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