Huada Chinese Academy Pre-enrollment Form

华大中文学校学生注册登记表


家长报名须知:

1 为了建立一个完整华大学生资料库, 我们力求它完善。 因此家长填写的字体应该端正, 清晰与正确。填写过程须逐一完成所要填写的栏目, 并要求所填写的资料是准确和真实
2)家长办理学生报名手续, 须认真审阅校方已经输入的资料。 凡是需要改的部分,在原来的资料上面划线, 把要更改的资料写在原来的下面
3)旧生家长报名须审阅过去一年的报名资料, 再次审阅学生手册上的五个章程: 1 办学宗旨  2 学校规章制度(3 家长值班制度(4 注册须知 5 学生守则 完成以上文件, 校方需向家长索取五个签名。
4)学生在读期间, 任何资料需要更改, 请尽快通知校方。
Instructions:
 (1) In order to maintain a complete student information database, we ask that you write legibly and verify that all information is accurate to the best of your knowledge. Please fill in as many blanks as possible.
 (2) When filling out this form, please verify that the information that the administration has retrieved is correct. If anything needs to be updated, please cross out the original information and write the new information below it.
 (3) In addition to filling out this form, please review the information contained in the following five sections of the student handbook: school vision, school liability, parents on duty, fees and refund policies, rules and regulations. After completion of the above, the administration will require signatures for each of the five sections.
 (4) While school is in session, please promptly notify the administration should there be any changes to the information on this form.

学生资料 ( Student Information )
学生姓名 (Student's Name)   课程 (Courses)
中文:    性别 (Sex): 男 (M)  女 (F) 中文班 (Chinese class):
English:

出生日期 (Birthdate):

(mm/dd/yyyy)

选修课 (Elective(s)):
        (Last name, First name) 年龄 (Age):
Regular school next fall:

家长资料 ( Parent Information )
父亲姓名 ( Father's Name )      工作 (Work Phone):   
  手提 (Mobile Phone): 
 
母亲姓名 ( Mother's Name )      工作 (Work Phone):   
  手提 (Mobile Phone): 

家庭资料 ( Home Information )
Street: 
City:     Zip code:   
Home phone:
Email address:

紧急情况处理 ( Emergency Handling Information )

紧急联系人 (家长以外)

Emergency Contact (Excluding parents)

姓 名 (Name):  电话 (Telephone):
家庭医生 (Family Physician) 姓 名 (Name):  电话 (Telephone):
指定医院 (Preferred Hospital) (Name):  电话 (Telephone):
医疗保险公司 (Health Insurance Company) (Name):  电话 (Telephone):

请列出您的孩子所有禁吃或过敏事物, 过敏药物和任何特别状况:

List all important medications and special conditions (allergies to medicine or food, etc.):