北京市中芯学校BeijingSMICPrivateSchool.doc

北京市中芯学校 ? SMIC Private School No. 9 Liangshuihe 2nd Street, Beijing Economic Technological Development Area, China, 100176 中国北京经济技术开发区凉水河二街9号 100176) Tel: +86 (10) 6785-3030 ext 2108 Fax: +86 (10)-5802 6784 入学申请表 APPLICATION FORM ? 中文部 Chinese Track ? 英文部 English Track **请申请人提供完整无缺的申请材料，申请材料将不予退还。 Once submitted, application materials become the property of SMIC School. 学生信息 (Student Information) 中文姓名 Legal Chinese Name 中文姓名 Chinese Name Preferred Name (if applicable) Passport Surname Passport First Name Passport Middle Name 性别 Gender 出生日期Birth Date (y/m/d) 户口所在地 Registered Residence 国籍 Nationality 出生地 Place of Birth 语言Spoken Language 证件类型 Certificate Type passport 证件号码 Certificate No. 签证类型 Visa Type 签证有效期至 Visa Exp. Date 预计到校日期 Expected Entry Date 现就读年级 Current Grade 申请年级 Applying for Grade Have your children ever been enrolled in our school? ____ No ____ Yes _____Class __________Name 家庭电话 Home Phone 家庭住址 Beijing Address 在开发区是否有住房 是/否 租住/购买 小区名称： 学习经历 (Education History) 学校 School 起止日期 Dates Attended 年级 Grades 学校联系电话 School Telephone 转出原因 Reason for transferring  家长/监护人 信息 (Parent/Guardian Info) 姓名 Name 关系 Relationship 国籍 Nationality 工作单位及职务 Employer Title 手机号码 Cell Phone 电子邮箱 Email Address Page 1 of 4 家长调查表 PARENT’S ADMISSIONS SURVEY 学校为提供优质服务,更全面地了解您孩子的需求和状况, 请如实准确地回答如下问题: Parents, we would like to get a full profile of your child in order to determine if our school is a good fit for your child’s needs and abilities, and to ensure a successful transition to SMIC Private School if he/she is admitted. Please answer the following questions as completely and candidly as you can. 1. 家庭状况Tell us about your family situation: ? 双职工 Two Parents, both working ? 双亲,一位在家 Two Parents, one at home ? 单亲, 无工作 Single Parent, at home ? 单亲, 工作 Single Parent, working