吴江太湖国际实验学校入学申请表.doc

吳江太湖國際實驗學校入學 Wujiang Taihu International School 申請表Application Form 中文姓名 Chinese Name 英文姓名 English Name 相片PHOTO 出生日期 Birthday Date 年 月 日 Y M D 性別 Gender 國籍 Nationality 年齡 Age 籍貫(老家) Hometown 介紹人 Recommended by 身分證號碼 ID Number 住址 Address 電子郵件 E mail 電話 Telephone 手機 Mobile 擬就讀年級 Level Applied 年級 Grade 曾就讀學校/年級 Name of Previous School /Grade 家 庭 狀 況 Status of family 父 Father 姓名 Name 聯絡電話 Phone 服務機構 Company 職業 Occupation 母 Mother 姓名 Name 聯絡電話 Phone 服務機構 Company 職業 Occupation 其他家庭成員 Family Members 姓名 Name 稱謂 Relationship 姓名 Name 稱謂 Relationship 姓名 Name 稱謂 Relationship 其他資料 Additional Information 1.申請人是否有學習、情緒或行為障礙？如是，請註明： Does the applicant have any educational, emotional or behavioral difficulty? If yes, please explain: □ 是，yes. □否，no _______________________________________________________________________________________ 2.申請人是否有健康、生理或情緒問題需要專家輔導或特別照顧？如是，請註明： Are there any health, physical or emotional factors for which the applicant has had professional intervention or special attention? If yes, please explain: □ 是，yes. □否，no _______________________________________________________________________________________ 3.申請人在目前就讀的學校是否接受諸如補習、家教及輔導？如是，請註明： Does the applicant receive any special services from his/her current school i.e. tutoring, counseling, etc,? If yes, please explain: □ 是，yes. □否，no ________________________________________________________________________________________ 4.特殊要求／如飲食..等 Special needs (diet, etc) □ 是，yes. □否，no ________________________________________________________________________________________ 5.其它要求Anything else we need to know □ 是，yes. □否，no ________________________________________________________________________________________ 6.為什麼想申請本校 Why would you like your child to attend our school? _______________________________________________________________