STARTALK 2023 Student Application Form
This form is to all 6th - 12th students who are interested in participating STARTALK, a tuition free federally funded Mandarin Chinese Learning Program which includes Pre-outreach program in spring 2023, in-person summer camp in July 2023 and post outreach program in fall 2023.
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Email *
Student's Name *
Gender *
Your school's name *
Grade in August 2023 *
Are you a Chinese heritage learner or the second language learner?
 *
How many years have you studied Chinese? *
How many times a week do you take Chinese classes?(No matter your current school, the Local Chinese school, or online)
 *
Your teacher's email address. 
A question link will be sent to the teacher.
 *
Race
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Religion
Home Address *
The First Parent/Legal Guardian's Name *
Contact Number *
Email Address *
The Second Parent/Legal Guardian's Name *
Contact Number *
Email Address *
Primary Insurer Name *
Primary Care Physician Name *
Contact Number *
Do you have any form of allergy? If yes, please specify *
How did you learn about STARTALK program? *
Required
Why do you want to join STARTALK Chinese Program? *
Do you plan to continue learning Chinese in high school and/or college?
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How importantly you think Chinese language skill will play a role in your future career? Please scale from 1-5. 1 - least important, 5 - very important
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I am older than 18 years old/ the parent or legal Guardian of the student, and have read the photo-video and allergy release form. *
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I am older than 18 years old/the parent or legal Guardian of the student, and agree that I/my child will not bring items that endanger personal safety into 2023 summer camp.
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Submit
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