Personal Information Form
Student's First Name:
Student's Last Name:
Date of birth (MM/DD/YYYY):
/
/
Gender: M
F
High School:
Grade in school(2008-9):
GPA:
Parent/guardian name:
Address:
TELEPHONE NUMBERS:
Home:
Parent/Guardian Work:
Cell Phone:
Email:
Program Selection
Which Session(s) would you like to attend? (Level availability is contingent upon demand.)
Session 1- June 23
rd
-July 16
th
Level 1
Level 2
Session 2- July 21
st
-August 13
th
Level 1
Level 2
Level 3
Are you available during the other session if enrollment does not permit your first choice ?
Yes
No
Please describe your experience with formal Chinese instruction:(i.e. high school courses, etc.)
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