Intent Survey Form - Aurora
The Intent Survey Form will help Great Wall Chinese Academy's planning on offer Chinese program (after-school, weekend school) in Aurora area. All information on this form is strictly confidential and for the school use only.
Great Wall Chinese Academy website:
英文姓名 Last name, First name
中文姓名, if student does not have Chinese name, repeat English name here
性别 Female, Male
Weekday after school
Weekend Saturday school
Weekend Sunday school
Intent to take what classes, check all that apply
Hig School Chinese
Grade in day school or home school currently
Home Phone 家庭电话
Last name, first name; 母亲姓名: 有中文姓名, 请填中文姓名
Cell Phone 联系电话
Last name, first name; 父亲姓名: 有中文姓名, 请填中文姓名
Contact Email 电子邮件
Contact Email 电子邮件
Parent Permissions 家长许可
I hereby consent to the use of any photographs/video tape or any media taken of my child by the school for the purpose of advertising or publicizing events, activities, facilities and programs of the school in newspaper s, newsletters, website, other publications, television, radio and other communications and advertising media.
I authorize the school to publish my student work for the purpose of showcasing and recognizing high achievement and good examples of student learning.
In a medical emergency, the school has my permission to take my child to the emergency room of the nearest hospital when I cannot be contacted, and the hospital staff has my authorization to provide treatment, which a physician deems necessary for the well being of my child.
How you find us
Check what applies 怎样知道长城中文学校
Referred by a friend
Chinese American Post 中美邮报
Colorado Chinese News 科州华报
Rocky Mountain Chinese 丹佛大都市报
Dragon Boat Festival 龙舟节
Chinese New Year Event 春节活动
By submit the form, we/our family hereby release, waive, discharge,and forever hold harmless to Great Wall Chinese Academy, its staff, promoters, and sponsors, from any loss or damage,and any claim of damages resulting from our participation in Great Wall Chinese Academy's program on account of any injury to my person, or property, whether caused by negligence or otherwise.
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