2018 美洲華語新生註冊表(繁體字版)
填表須知:
1. 每個家庭填寫一份。One form for each family
2. 請先閱讀「註冊須知」。Please read Registration Information first.
3. 有*必須填寫,請工整填寫。Fields with * are required. Please print.
Email address *
一、學生基本資料 Student Info:
(1) 第一位學生 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 *
課本 Textbook *
新學年的年級 Grade in new school year *
過敏、注意事項 Allergies, Remarks
Your answer
曾經就讀的中文學校名稱 Previous Chinese School:
Your answer
(1) 第二位學生 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
課本
新學年的年級 Grade in new school year *
過敏、注意事項 Allergies, Remarks
Your answer
曾經就讀的中文學校名稱 Previous Chinese School:
Your answer
二、家長/監護人資料 Parent / guardian information:
(1) 母親或第一位監護人 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
電郵地址 Email Address *
Your answer
手機號 Cell Phone Number *
Your answer
微信號 WeChat ID
Your answer
Line ID
Your answer
與學生關係 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
電郵地址 Email Address
Your answer
手機號 Cell Phone Number
Your answer
微信號 WeChat ID
Your answer
Line ID
Your answer
與學生關係 Relationship to the student
Your answer
三、家庭住址 Family address:
街名 Street *
Your answer
城市 City *
Your answer
郵遞區號 ZIP *
Your answer
社區名稱 Community Name
Your answer
四、緊急聯絡資訊(非父母)Emergency Contact Information:
聯絡人姓名 Full Name
Your answer
聯絡人電話 Cell Phone Number
Your answer
五、醫師與保險 Physician and Insurance Info:
醫師姓名 Physician Name
Your answer
醫師電話 Physician Phone Number
Your answer
五、學雜費用及報名手續 Fees:
學雜費 Tuition / Material Fee
$495 學費 Tuition
$45 教材費 Material
$35 註冊費(每家) Registration Fee
第一位學生
第二位學生
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
合計費用 Total Cost *
Your answer
付款方式 *
Required
報名手續:
Photo & Video Permission (Please mark the square) *
Required
Agreement (Please mark all the squares) *
Required
申請人 applicant
姓名 Name *
Your answer
聯絡電話 Phone Number *
Your answer
申請日期 Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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