2020-21 Student Health Record Form
2020-21 學生健康紀錄表 (Please list Parent/Guardian's Email address below / 請填寫家長/監護人聯絡電子郵件)
Email address *
Student Information - Please fill out one form per student
學生個人資料 - 請貴家長替每一位子女分開填寫本表格
Signature of parent or guardian (家長 / 監護人簽名) *
Parent / Guardian's Email address (填寫本表單的家長/監護人電子郵件信箱) *
Student Grade (貴子女目前就讀的年級為) *
Student’s Last Name (學生的姓) *
Student’s First Name (學生的名) *
Student’s Middle Name - if any (學生若有其他中文名)
Student's Date of Birth (學生的出生年月日) *
MM
/
DD
/
YYYY
Student's Gender (學生性別) *
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