New Form
1.
The school you would like to register at
Los Angeles Unified School District
Cerritos Chinese School
United Chinese Learning Center
Irvine Chinese School 1:30PM~4:30PM
Irvine Chinese School 6:30PM-9:30PM
Fullerton Chinese School
Vaughn School in San Fernando
San Feranando Valley Chinese School
Chiao Hsin Chinese Language School
USC Shen Win Chinese Institute
A+ Chinese School
2.
Your Email Address
3.
Your Last Name
4.
Your First Name
5.
Your Middle Name
6.
Gender
M
F
7.
Birth Date (MM/DD/YYYY)
8.
Your Cellular Number
9.
Have been living in the US since (year)
10.
Home Street Address
11.
City
12.
State
13.
Zip Code
14.
Home Phone (nnn-nnn-nnnn)
15.
Current School Name
16.
School Website Address
17.
Current Grade Year in your school
18.
Current unweighted GPA (A=4.0)
19.
Current weighted GPA (Honor class A=5.0)
20.
Your School Open Date of 2007 Fall Term
21.
Do you understand Chinese?
No, skip to question No. 30
Yes.
22.
How many years have you studied Chinese?
23.
Where did you study Chinese?
24.
Do you speak or listen Mandarin at home?
No.
Yes
25.
Your Chinese language proficiency level
26.
In speaking:
Novice-Low
Novice-Mid
Novice-High
Intermediate-Low
Intermediate-Mid
Intermediate-High
Advanced
Superior
27.
in listening
Novice-Low
Novice-Mid
Novice-High
Intermediate-Low
Intermediate-Mid
Intermediate-High
Advanced
Superior
28.
in reading
Novice-Low
Novice-Mid
Novice-High
Intermediate-Low
Intermediate-Mid
Intermediate-High
Advanced
Superior
29.
in writing
Novice-Low
Novice-Mid
Novice-High
Intermediate-Low
Intermediate-Mid
Intermediate-High
Advanced
Superior
30.
Please identify your ethnic group:
African American, Black
American Indian/Alaska Native
Chinese American/Chinese
Other Asian American/Asian
Mexican American, Chicano
Puerto Rican
Other Hispanic, Latino
Native Hawaiian, Pacific Islander
White or Caucasian
Others
31.
Parent's or Guardian's Last Name
32.
Parent's or Guardian's First Name
33.
Parent's or Guardian's Daytime Phone No.
34.
Can we use pictures/video of your child?
35.
Do you need financial aid on tuition?
No
Yes
36.
Do you agree no tardyness or absences
Yes.
No.
