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2023 - 2024 Student Enrollment
Please complete one for each student
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* Indicates required question
Email
*
Your email
Student Last Name:
*
Your answer
Student First Name
*
Your answer
Chinese Name:
Your answer
Gender:
*
Male
Female
Birth Date:
*
MM
/
DD
/
YYYY
Father's Name (Last, First):
*
Your answer
Mother's Name (Last, First):
*
Your answer
Email Address:
*
Your answer
Home Address:
*
Your answer
Father's Cell Phone Number:
*
Your answer
Mother's Cell Phone Number:
*
Your answer
Home Phone Number, if available:
Your answer
Chinese Language Spoken at Home: please indicate Cantonese or Putonghua and Level
*
Cantonese
Putonghua
Often
Sometimes
Never
Do you and your family attend church regularly?
*
Yes
No
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