2018 美洲华语新生注册表(简体字版)
填表须知:
1. 每个家庭填写一份。 One form for each family
2. 请先阅读「注册须知」。 Please read Registration Information first.
3. 有*必须填写,请工整填写。 Fields with * are required. Please print.
Email address *
一、学生基本资料 Student Info:
(1) 第一位学生 First Student
英文姓 Last Name *
Your answer
英文名 First Name *
Your answer
中文姓名 Chinese Full Name
Your answer
生日 Birthday (mm/dd/yyyy) *
MM
/
DD
/
YYYY
性別 *
课本 Textbook *
新学年的年级 Grade in new school year *
过敏、注意事项 Allergies, Remarks
Your answer
曾经就读的中文学校名称 Previous Chinese School:
Your answer
(1) 第二位学生 Second Student
英文姓 Last Name
Your answer
英文名 First Name
Your answer
中文姓名 Chinese Full Name
Your answer
生日 Birthday (mm/dd/yyyy)
MM
/
DD
/
YYYY
性別
课本 Textbook
新学年的年级 Grade in new school year
过敏、注意事项 Allergies, Remarks
Your answer
曾经就读的中文学校名称 Previous Chinese School:
Your answer
二、家长/监护人资料 Parent / guardian information:
(1) 母亲或第一位监护人 Mother or First guardian:
英文姓 Last Name *
Your answer
英文名 First Name *
Your answer
中文姓名 Chinese Full Name
Your answer
电邮地址 Email Address *
Your answer
手机号 Cell Phone Number *
Your answer
微信号 WeChat ID
Your answer
Line ID
Your answer
与学生关系 Relationship to the student
Your answer
(2) 父親或第二位監護人 Father or Second guardian:
英文姓 Last Name
Your answer
英文名 First Name
Your answer
中文姓名 Chinese Full Name
Your answer
电邮地址 Email Address
Your answer
手机号 Cell Phone Number
Your answer
微信号 WeChat ID
Your answer
Line ID
Your answer
与学生关系 Relationship to the student
Your answer
三、家庭住址 Family address:
街名 Street *
Your answer
城市 City *
Your answer
邮递区号 ZIP *
Your answer
社区名称 Community Name
Your answer
四、紧急联络资讯(非父母)Emergency Contact Information:
联络人姓名 Full Name
Your answer
联络人电话 Cell Phone Number
Your answer
五、医师与保险 Physician and Insurance Info:
医师姓名 Physician Name
Your answer
医师电话 Physician Phone Number
Your answer
五、学杂费用及报名手续 Fees:
学杂费 Tuition / Material Fee
$495 学费 Tuition
$45 教材费 Material
$35 注册费(每家)Registration Fee
第一位学生
第二位学生
制服尺寸(制服含每人一件)Free Uniform (one/student)
XS
S
M
L
XL
第一位
第二位
合计费用 Total Cost *
Your answer
付款方式 *
Required
报名手续:
Photo & Video Permission (Please mark the square) *
Required
Agreement (Please mark all the squares) *
Required
申请人 applicant
姓名 Name *
Your answer
联络电话 Phone Number *
Your answer
申请日期 Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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