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新东方课后班报名表 WA After-School Registration Form
Address: 99 Clarksville Rd, West Windsor, NJ 08550
Phone: (609)358-2402 (917)362-0567 (732)213-9618 Fax: 732-284-3188
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* Indicates required question
学生资料 Student Information
学生姓名 Name
*
Your answer
中文名字 Chinese Name
Your answer
性别 Gender
*
M
F
生日 DOB
*
MM
/
DD
/
YYYY
学校 Public School
*
Your answer
年级 Grade
*
Grade in Sept. 2019
Choose
K
1
2
3
4
5
6 and up
中文课 Chinese Class
*
是否在 After School 上中文课?
Choose
Yes
No
中文课年级 Chinese Class Grade
Choose
K
1
2
3
4
5
6
None
上课日期 Program
*
Please check the days the child is attending
Monday
Tuesday
Wednesday
Thursday
Friday
Required
校车 School Bus
Choose
School bus offered by township
School bus by WA (fees applied)
Drop-off personally
过敏 Allergy
请填写所有过敏的食物和药物。 Please specify any food or drug allergy.
Your answer
备注 Notes
Your answer
还有其他子女报名？Register another child?
*
同一家庭的多个子女可享受优惠。Discount is offered to children from the same family.
Yes
No
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