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Student Form

Student's Full Name

*

Date of Birth

*

Current Grade

*

Current School

*

Start Date

*

Please provide us with the specific days your child will be attending the program

*

Please let us know if your child needs a Mandarin lesson.

*

Allergy & Medical History

*

Parent's Full Name

*

Address

*

Email

*

Enter the email you used to make the purchase

Phone Number

*

Emergency Contact Info

*

Phone Number

*

Email

*

How did you hear about us?

I, Parent/Guardian of the applicant, have read and fully understood the Enrollment Policy & Liability Waivers. By checking this box, I confirm that I will abide by all the terms

*

I, Parent/Guardian of the applicant, have read and fully understood the Enrollment Policy & Liability Waivers. By checking this box, I confirm that I will abide by all the terms

I accept