JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2022 Summer Camp 夏令營
WALNUT CHINESE LANGUAGE CENTER
20850 CARREY RD. WALNUT, CA 91789
909-594-8880
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Enrollment Type
*
Entire Day 全天
Morning Chinese Class Only 上午中文班
Afternoon Classes Only 下午課程
Number of Weeks 參加週數
*
Choose
1
2
3
4
5
6
7
8
Select the the weeks to attend 請在參加的週數打勾
*
1st week
2nd week
3rd week
4th week
5th week
6th week
7th week
8th week
Required
Field Trips
*
Will join 有意願參加
Won't join 沒有意願參加
Student Name 姓名 (Chinese and English )
*
Your answer
DOB 生日
*
Your answer
Gender 性別
*
Male 男
Female 女
School 目前就讀學校
*
Your answer
Grade 年級 on August/2022
*
Choose
1
2
3
4
5
6
7
N/A
If selected N/A, please state current school grade 目前就讀年級 (非1-7）
Your answer
Chinese Proficiency 中文程度
*
None 未讀過
Pinyin
Last completed Chinese textbook level 已讀完美洲或其他 ____ 第____冊
*
Your answer
*
Traditional 繁體
Simplified 简体
Native Language 母語
*
Mandarin 國語
Cantonese 粵語
English 英語
Other 其他
Required
Address 住址
*
Your answer
Parent/Guardian Name 父母 / 監護人名字
*
Your answer
Parent/Guardian's Relationship to Student 關係
Mother 母親
Father 父親
Other 其他
Clear selection
Parent/Guardian's Phone Number (Home)
Your answer
Parent/Guardian's Phone Number (Cell)
*
Your answer
Parent/Guardian's Email
*
Your answer
Family Doctor's Name and Telephone
Your answer
Make Payment
*
by Check 以支票支付
by Zelle (
wclc20850@gmail.com
)
other 其他
Required
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
