2021 Coffee Socials | 咖啡社交聚會

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Attendee Sign up | 報名表

* COVID-19 protocols will be enforced | 須遵守防疫措施

1. Mask wearing required | 需配戴口罩
2. On site temperature check required | 現場量測體溫
3. Completed COVID-19 Health Screening prior to in-person social events. COVID-19 Health Screening form will be sent with your registration confirmation email. | 前往咖啡聚會前務必完成 COVID-19 健康篩查。 COVID-19 健康檢查表將與註冊確認電郵一同寄送給您。

Which location and date you would like to go to? | 請選擇您欲參加的場次。 *

Tuesday, South Bay Coffee Social - 11/30/21

Thursday, East Bay Coffee Social - 12/2/21

必填

First Name | 名字 *

Last (Family) Name | 姓氏 *

Email Address | 電郵地址 *

Phone Number | 連絡電話 *

What city do you live in? | 居住城市名 *

What is your family ethnicity? | 您家庭的族裔為何? *

Chinese | 華裔

Japanese | 日裔

Korean | 韓裔

Vietnamese | 越南裔

其他:

What language(s) does your family speak? (Check all that apply) | 您家庭中慣用語言為何? (可複選) *

English

Chinese (Cantonese) | 粵語

Chinese (Mandarin) | 普通話

Japanese | 日本語

Korean | 한국어

Vietnamese | ngôn ngữ tiếng Việt

其他:

必填

What are the age(s) of your special needs loved one(s)? (Check all that apply.) | 您的特殊需要子女年齡為何? (可複選) *

Under 3 | 三歲以下

School-age (3 to 18) | 學齡期 (3到18歲間)

Post-Secondary (18 - 22) | 高中畢業後教育期 (18到22歲)

Over 22 | 成年期 (22歲以上)

必填

Are you or your special needs loved one currently a client of the Regional Center? Which one? | 您或您的特殊需要子女目前為區域中心的客戶嗎? 是哪個區域中心? *

Regional Center of the East Bay (RCEB) | 東灣區域中心

San Andreas Regional Center (SARC) | 聖安德魯斯區域中心

Golden Gate Regional Center (GGRC) | 金門區域中心

Other Regional Centers | 其他區域中心

I am not a client of the Regional Center. | 我不是區域中心的客戶

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