亚裔青少年创媒联盟“创媒少年”报名表  Asian Asian Youth Creative Media Alliance (AYCMA)
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姓名  Name  *
出生年月  date of birth

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性别  gender *
年级  grade *
所在学校  School  *
本人联系方式【邮箱、电话（如果有）】 Contact information [Email, phone number (if available)] *
家长姓名、联系电话及微信  Parent's name, contact number and wechat *
家庭住址  Home Address *
本人或家长备注  Personal or parent remarks *
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