CLSC New Student Registration Form

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Thank you for your interest in CLSC. Our Principal/Dean will be in touch with you. Please add the following email addresses to your Contacts so that the responses from CLSC can reach your Inbox instead of Junk/Spam folder.
clsc.principal@clscweb.org
clsc.dean@clscweb.org
clsc.registrar@clscweb.org
clsc.connect@clscweb.org

Email *

1. Student 1 - Name (Enter Last Name, First Name) Example: Wang, Ada *

1a. Student 1 - Chinese Name, if applicable.

1b. Student 1 - Birth Month and Birth Year (MMYYYY). Example: 012006 *

2. Student 2 - Name (Enter Last Name, First Name). Example: Wang, Ada

2a. Student 2 - Chinese Name, if applicable.

2b. Student 2 - Birth Month and Birth Year (MMYYYY) Example: 022006

3. Student 3 - Name (Enter Last Name, First Name). Example: Wang, Ada

3a. Student 3 - Chinese Name, if applicable.

3b. Student 3 - Birth Month and Birth Year (MMYYYY) Example: 032006

4. Does the student speak Chinese at home? *

5. Did the student take Chinese lessons before? If Yes, how many years and at which school?

6. Student's preferred language class *

Mandarin

Cantonese

7. Pick one of the choices that best describes the Chinese speaking level of the student. *

8. Pick one of the choices that best describes the Chinese reading/writing level of the student. *

9. Will it be acceptable, if the student(s) were placed in a class with younger classmates? *

Yes

10. Are you able to regularly attend classes on Sundays, 1:30pm to 3:45pm? (Note: If virtual class is offered, the duration of the class is from 60 to 120 minutes.) *

Yes

11. Primary Contact - Phone Number *

12. Primary Contact - Email Address * *

13. Alternative Contact Phone Number

14. Home Address * *

15. Name of Student's Parent/Guardian 1 (Enter Last Name, First Name) Example: Wang, Mary

15a. Chinese Name of Parent/Guardian 1, if applicable.

15b. Email address of Parent/Guardian 1

15c. Parent/Guardian 1, are you the student's

Mother

Father

Guardian

Clear selection

16. Name of Student's Parent/Guardian 2 (Enter Last Name, First Name) Example: Wang, Joe

16a. Chinese Name of Parent/Guardian 2, if applicable.

16b. Email Address of Parent/Guardian 2

16c. Parent/Guardian 2, are you the student's

Mother

Father

Guardian

Clear selection

17. Please review CLSC Code of Conduct
*

By checking the box, I acknowledge that I have read and agreed to the terms of the CLSC Code of Conduct for virtual and in-person classes.

Required

18. Please review CLSC Liability Waiver *

By checking the box, I acknowledge that I have read and agreed to the terms of the CLSC Liability Waiver.

Required

19. Please review CLSC Health Policy *

By checking the box, I acknowledge that I have read and agreed to adhere to the CLSC Health Policy.

Required

20. Media Release/Internet Exposure

In the course of school activities, CLSC staff or organizations working with CLSC occasionally photograph, video record, or audio record students, and/or publish their names, likenesses, or school work in media intended for a public audience. These media may include printed documents, websites, social media, television, or other venues.

Please choose an option below as it relates to your child(ren):

I GIVE PERMISSION for my child to be included in photographs, videos, or audio recordings intended for public audience.

I DO NOT want my child included in photographs, videos, or audio recordings intended for public audience. NOTE: Choosing this option will not prevent your child's inclusion in photos, videos, or audio recordings that are taken during extracurricular events open to the public, such as student performances, speech and word recognition competitions, cultural activities, or graduation ceremonies.

Required

21. Comments or information you like to share with us?

22. Whom May We Thank for Referring You? (Enter Referrer's Last Name, First Name) Example: Chen, Jane

23. For CLSC Admin. Use Only (Class assigned by Principal/Dean)

A copy of your responses will be emailed to the address you provided.

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