新东方课后班报名表 WA After-School Registration Form
Address: 99 Clarksville Rd, West Windsor, NJ 08550
Phone: (609)358-2402 (917)362-0567 (732)213-9618 Fax: 732-284-3188
学生资料 Student Information
学生姓名 Name *
Your answer
中文名字 Chinese Name
Your answer
性别 Gender *
生日 DOB *
MM
/
DD
/
YYYY
学校 Public School *
Your answer
年级 Grade *
Grade in Sept. 2019
中文课 Chinese Class *
是否在 After School 上中文课?
中文课年级 Chinese Class Grade
上课日期 Program *
Please check the days the child is attending
Required
校车 School Bus
过敏 Allergy
请填写所有过敏的食物和药物。 Please specify any food or drug allergy.
Your answer
备注 Notes
Your answer
还有其他子女报名?Register another child? *
同一家庭的多个子女可享受优惠。Discount is offered to children from the same family.
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