入学申请表
Application Form

申请人信息

*专业方向Intended Major
 
*学习时长Study Length
 
*申请年级Entrance Grade

*期望入学时间Expected Entry Period

学生信息

*中文姓名Chinese Name
 
英文名English Name
*性别Gender
*国籍Nationality
 
*出生日期Date of Birth
 

*民族Chinese Ethnicity
 
*身份证号 / 护照号ID / Passport No.
 
*家庭电话Home Phone
 
*家庭住址及邮编Home Address &Postcode
 

学生教育背景

*现就读学校名称
Current School Name
 
*就读时间 开始
Dates Attended From

结束
To

之前就读学校名称
Previous School Name
就读时间 开始
Dates Attended From

结束
To

家庭信息

父亲/监护人Father/Guardian 母亲/监护人Mother/Guardian
姓名Full Name  

 

国籍Nationality

手机Mobile  

 

邮箱Email  

 

教育背景
Education Background

工作单位
Company Name

职务Occupation

*首选联系方式Preferred Contact Method

紧急联系方式

*姓名
Full Name
 
*与学生关系
Relationship to the applicant
 
*手机
Mobile
 

学生健康状况

此学生有无任何健康问题需要员工注意到?如是,请详细说明
Does this student have any health problems that the staff should be aware of? If yes, please explain:
此学生有无任何药物和食物过敏史?如有,请详细列出
Is this student allergic to any medicine and food? If yes, please list them all:
此学生是否曾经接受过特殊教育或者被诊断出有可能出现影响学习的情况(例如:学习辅助支持、阅读 障碍、注意力不集中症、才华出众或天赋极高)?如是,请详细说明
Has the student received special educational services in the past or been diagnosed with a condition that could impact learning (e. g. Learning Support, Dyslexia, ADHD, Talented & Gifted)? If so, please explain:

*预防疫苗

您的孩子接种过何种疫苗
Have you child received any vaccination for?
其他Other

*声明

我们可能出于推广目的使用您所登记的个人资料,例如向您发送新闻简报、最新消息和宣传资料。若您同意接收此类信息或资料,请在签名前勾选以下方格以示同意。
We may use your personal data contained herein for marketing purposes, such as sending newsletter, updates and promotional materials to you. If you agree to receive such information or materials, please indicate your consent before signing by ticking the boxes below.
1. 本人确认,本人为该学生的家长或监护人。
I confirm that I am the parent or guardian of the student.
2. 本人授权中音鼎石使用、核对和处理本人及本人子女在本教育咨询表中所登记的资料。
I authorize CCPS to use, check and process my and my child’s information that is provided on this form.
3. 本人授权学校使用本人及本人子女出席学校举办的活动所拍摄的相关照片或图像于其宣传资料当中。
I authorize CCPS to include photographs or images of myself and my child taken at an event held by the School in its promotional materials.
4. 本人知悉,一旦成功申请并入学,只要本人子女仍是学校学生,则本人及本人子女的资料将成为学生档案的一部分,且可能用于符合相关法规规章所规定的各种用途及随后的手续。
I understand that upon successful application and subsequent admission to the School, my and my child’s data will become a part of student record and may be used for all purposes as prescribed under relevant rules and regulations as well as attendant procedures, so long as my child remain a student of the School.
5. 本人声明,本申请表中所提供的信息准确完整。本人知悉,若提供任何不实信息将导致申请资格被取消。
I declare that the information given in support of this application is accurate and complete. I understand that any misrepresentation will disqualify my application.

I understand and agree with the above declarations.

*签字

家长/监护人签字Signature of Parents/Guardian
 



填表过程中,您若有任何疑问,可以直接电话联系学校招生部 4000-581-587