2022-2023 CAoC Registration Form 克里夫蘭中文書院學生註冊單
Please submit ONE form for EACH student. Please complete this form by August 31st. All fees are due by August 31st, 2022. The first day of the school is September 10th, 2022.

$50 LATE FEE WILL BE COLLECTED AFTER 8/31. Thank you!

請一位學生填寫一份註冊單。請於8月31日前完成報名及繳費，逾期將酌收$50作業費用。開學日期為9月10日。謝謝您的合作！
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Email *
Student Information (Required) 學生基本資料
First Name 英文名字 *
Last Name 英文姓氏 *
Chinese Name 中文姓名 （請打中文）
Date of Birth 生日 *
MM
/
DD
/
YYYY
Gender 性別 *
Language Classes 班級: *
CSL Adult
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2022-2023 Annual Tuition and Fees 學費與其他費用
Tuition: $500
孩童班學費: $500

In summary:
$500 for one student from one family
$1,000 for two students from one family
$1,470 for three students total ($30 discount for the third student) from one family
$1,940 for four students total ($30 discount for each of the third and fourth student) from one family

總計
一戶一位學生 總額$500
一戶兩位學生 總額$1,000
一戶三位學生 總額$1,470 (第三位學生免除註冊費$30)
一戶四位學生 總額$1,940 (第三位與第四名學生各免除註冊費$30)

Please note that if your check is bounced by the bank for any reason, whatever amount that your bank charges the school will be added to your total fees.

請注意, 如果您的支票遭到銀行退票, 您需要支付相關退票罰金.
Remit by sending a check via mail 經由郵寄支票付款

1. Please make the check* payable to "CAoC". 支票受款人請填寫 "CAoC"

2. Please write all the students' names on the Memo section. 請將學生姓名填寫在支票備註欄

3. Please mail it to: 請將支票郵寄至以下收件人與地址

Rachel Timura
7640 Settlers Court
Mentor, OH 44060

*Please make sure sufficient funds are in your check-writing account. For a bounced check, any bank fee or penalty that is charged to CAoC will be the check writer's responsibility.

*請注意, 如果您的支票遭到銀行退票, 您需要支付相關退票罰金.
Remit via Zelle 透過Zelle轉帳付款
1. Please find CAoC's Zelle account by searching caoc.treasurer@gmail.com 請在銀行的Zelle介面搜尋學校帳號

2. Please leave student's name, class, and your phone number in the memo (within the Zelle interface) by the following format: Kevin Liao (CSL 2), Charlotte Liao (Traditional 4), Phone: 123-456-7890. 請在Zelle的備忘錄欄填寫學生的姓名, 班級以及您的聯絡電話

3. Feel free to send a confirmation email to caoc.principal@gmail.com once the payment is sent (it's optional). 完成繳費後，歡迎發送電郵給校長信箱

*Please note, once the Zelle transaction is completed (usually in a few hours if not immediately) it cannot be cancelled from our end. If you would like to ask for refund, please contact Principal Lin (caoc.principal@gmail.com)

*請注意, 轉帳所需時間一般為數小時內. 一旦轉帳完成, 校方無法取消該轉帳. 如需退款, 請與校長聯繫.
Primary Parent/ Guardian/ or Adult Student Information 家長/監護人/成人班學生 基本資料
This is required information.
Please Select 請選擇 *
First Name 英文名字 *
Last Name 英文姓氏 *
Chinese Name 中文姓名 （請打中文）
Phone 1 聯絡電話 1 *
Phone 2 聯絡電話 2
Email 電子郵件信箱 *
Address 1 住址 1 *
Address 2 住址 2
City 城市 *
State 州名 *
ZIP Code 郵遞區號 *
Occupation 職業
Second Parent/Guardian Information 第二家長或監護人基本資料
This is optional information.
Please Select 請選擇
Clear selection
First Name 英文名字
Last Name 英文姓氏
Chinese Name 中文姓名
Phone 1 聯絡電話 1
Phone 2 聯絡電話 2
Email 電子郵件信箱
Address 1 住址 1
Address 2 住址 2
City 城市
State 州名
ZIP Code 郵遞區號
Occupation 職業
In the event we can not get a hold of the parents or guardians, please provide emergency contact person number (Required): 請提供緊急聯絡人資料，以方便我們在聯絡不到家長或監護人時可以聯絡。
Emergency Contact 緊急聯絡人 *
Phone 電話 *
Special Note. If your child has any allergy or other special medical situation, please inform us as soon as possible. 小孩有任何需要注意的健康狀況嗎? 如過敏等...
Health Concerns 需要注意的健康狀況
2022-2023 Chinese Academy of Cleveland Waiver Statements 2022-2023 克里夫蘭中文書院家長同意書
We/I hereby release, discharge and agree to hold harmless Chinese Academy of Cleveland, its board members and staff, as well as Shaker Heights School and its staff and all persons acting under the permission or authority, from a liability whatsoever for any and all claims of any nature which may raise out of our/my attendance at the Chinese Academy of Cleveland, and/or purchase and / or consumption of food and / or snacks offered through the Chinese Academy of Cleveland during snack time, special luncheon, and special events sponsored by the Chinese Academy of Cleveland such as Chinese New Year celebration, outdoor picnic, and end-of-year luncheon. This release covers us/me and any minor members of our/my family. *
We/I hereby also agree on behalf of ourselves / myself and any minor members of our / my family to allow the staffs and board members of the Chinese Academy of Cleveland to release electronic or paper photographs of us / me and any minor members of our/ my family on published materials including newspaper articles, internet websites, and video / radio productions associated with the reporting and promotion of activities associated with the missions, actions, and activities of the Chinese Academy of Cleveland. *
Furthermore, in case of emergency and my designated emergency contact cannot be reached, permission is granted to have my child treated by doctor or hospital appointed by the Chinese Academy of Cleveland or its authorized personnel. *
Withdraw and Refund Policies: 休學及退費須知：
1. Classes are subject to cancellation due to low enrollment. 如果學生人數不足，課堂可能會被取消。
2. Preschool, Pre-K and Kindergarten students’ parents need to be available during class time in order to help your own child when the needs arise. 家中若有五歲以下小朋友就讀, 上課期間請盡量能夠保持聯絡以便協助您的孩子學習。
3. Refund Policies can be found at the end of the Registration information on our website. 退費細則請詳見學校網頁的註冊分頁。
Please confirm you agree to abide by our school’s refund policies stated in the Registration Information. *
Questions or Comments
A copy of your responses will be emailed to the address you provided.
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