Prospect Chinese Academy 2017 Fall Registration Form
Student First Name *
Your answer
Student Last Name *
Your answer
Student Chinese Name *
Your answer
Student birthday *
MM
/
DD
/
YYYY
Student's school grade in the year of 2017-2018 *
Student's regular school name *
Your answer
Parents Name *
Your answer
Parents email address *
Your answer
Parents phone number *
Your answer
Parents Home Address *
Your answer
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