Adult Class 1st Semester - Enrollment 成人會話班報名表
Dear Students,

San Marino School District Superintendent Dr. Jeff Wilson announced that all classes and activities will now use a 100% virtual model of teaching and rigorous learning. For safety concern, the Chinese School of San Marino committee also confirmed to have the same ONLINE learning model for Adult Class as well and the first school day is scheduled on September 12. If you have any questions, please contact the office. Thank you!

1st Semester: September 12, 2020 to January 23, 2021(13 weeks)
Tuition Fee: $200

□ Beginning Level: 9:00 – 10:20 A.M.
□ Intermediate, Advanced Level: 10:40 – 12:00 P.M.
□ Beginning Level: 2:00 – 3:20 P.M.

*After submitting, you will be receiving confirmation and payment instruction. Thank you!
**Please complete one for each student.



第一學期: 九月十二日到二O二一年一月二十三日(一共13週)
學費: $200

□ 初級: 9:00 – 10:20 A.M.
□ 中級, 高級: 10:40 – 12:00 P.M.
□ 初級: 2:00 – 3:20 P.M.

*送出報名表後, 您將會收到確認及付款訊息, 謝謝您!
學生的英文姓名 Student's English Full Name *
學生的中文姓名 Student's Chinese Full Name
學生郵件信箱 Student's Email Address *
郵寄地址 Mailing Address *
報名的課程 Saturday Program *
本人同意並授權聖瑪利諾中文學校拍攝、修飾、使用、公開展示本人與法定代理人的肖像、影片與聲音。聖瑪利諾中文學校可使用授權肖像來展示及宣傳服務項目。並得用於設計、製作、印刷、傳播、網站與新聞等各項廣告宣傳資料或以各種方式來呈現授權肖像之全部或部分且可公開發表,及著作權法賦予著作人所擁有之權益。聖瑪利諾中文學校可無須再通知或經由本人與法定代理人同意,但於公開發表時必須尊重個人形象,不得發表於非正當管道。 I hereby give the Chinese School Of San Marino permission to use photographs/ video/ sound of the adult and the minor(s) named below for publicity, promotion, news releases, videos, advertisements and web use of the Chinese School Of San Marino. This might also apply to written compositions or visual art pieces of minors if they are published. I hereby release and discharge the Chinese School Of San Marino from any and all claims arising out of the use of the photography/ video/ sound that I or the minor(s) listed may have in this regard. *
1. Zoom為成人班線上課程老師所使用的同步教學平台,請您先在自己的設備上安裝完畢。如果您需要安裝指南請聯繫辦公室。 2. 任何一個課程五人為最低開班要求,請配合及理解報名以後不接受任何退款。 3. 請遵守實體教室的課堂規則,勿走動,勿飲食。 4. 為了確認學習情形,請同意打開攝影機提高參與課程的效果。 5. 請尊重隱私,勿錄影。 6. 開課之前會分別安排來辦公室領取課本。 1. Our teachers are using Zoom, this software for online course during this semester. Please install it before the class starts. If you need the instruction please contact the office. 2. Five students minimum for each class. Please understand there is no any refund for this Adult Class after enrolling. 3. Please follow the physical classroom rule, no walking and no eating. 4. Please consent to turn on the camera during the class to join the teacher together for effective learning. 5. Please respect the privacy, no recording. 6. We will arrange a safe schedule for picking up textbook before the class starts. *
緊急聯絡人姓名及電話 Emergency Contact /Phone No. *
Electronic Signature/Date 電子簽名/日期 * *
以下的電子簽名及日期聖瑪利諾中文學校視為等同手寫簽名的效力,我確認所有提供的訊息都是正確無誤的。 The electronic signature below and its related fields are treated by Chinese School of San Marino like a handwritten signature on the paper form. I affirm that all the information provided is true and correct to the best of my knowledge.
請您提供其他的意見。 Any other comments and/or questions?
Never submit passwords through Google Forms.
This form was created inside of Chinese Club/School of San Marino. Report Abuse