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113學年度國中部新生入學學力評量報名表
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* Indicates required question
Email
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Your email
學生中文姓名 Student's Chinese Name
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Your answer
學生英文姓名 Student's English Name (別名如: John Smith)
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Your answer
學生出生日期 Date of Birth 以西元2011年9月2日~西元2012年9月1日出生為限 (民國100年=西元2011年)
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MM
/
DD
/
YYYY
學生性別 Gender
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男BOY
女GIRL
身分證號 ID Number
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Your answer
家長姓名 Name of the Parent (or Guardian)
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Your answer
聯絡人稱謂 Relationship (如:父女、母子、祖孫...)
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Your answer
家長主要聯絡 Email （行前通知將寄至您提供的 Email 信箱,僅留一個主要Email)
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Your answer
家長主要聯絡行動電話 Mobile Number(僅留一個主要電話)： Ex.091234578
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Your answer
聯絡地址 Home Address：
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Your answer
住家電話or行動電話2 Home Phone Number(僅留一個主要電話)：Ex.03-1234567or 0900123456
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Your answer
是否有兄弟姐妹目前就讀有得 （請填班級和姓名） Currently, do you have any sibling(s) attend Yoder Bilingual Academy? (Please student name and class #)
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Your answer
您如何認識有得？ How did you learn about Yoder Bilingual Academy?
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有得臉書 Yoder Facebook Page
搜尋有得網站 School Website
親友介紹 Word of Mouth
招生宣傳單 Flyer
公車廣告 Bus Advertisement
國小升學輔導活動 School Admissions Briefing for Elementary School
招生資料夾 Folders
參訪有得 Campus Tour
大樓外牆廣告 Advertisement on the wall of the building
Other:
畢業小學名稱 Name of Primary School
*
Your answer
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