If you are a current student, please go to step 2 directly to register your class.

如果你是我們目前在冊的學生，請直接跳到步驟 2 進行課程註冊.

學生資料 Student Information

學生英文名字* Student English First Name

學生英文姓氏* Student English Last Name

學生中文姓名 Student Chinese Name if available (Chinese characters only)

性別* Gender

—Please choose an option—FemaleMaleOther

出生日期* Birth date

電子郵件* Email

主用電話號碼* Primary phone number

其他電話號碼 Secondary phone number

街道地址（門牌號）* Street address（apt#.)

城市* City

州* State

—Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

郵政編碼* ZIP Code

緊急聯絡人士資料 Emergency Contact Information

緊急聯絡人士姓名* Name of Emergency Contact Person

緊急聯絡人士與學生的關係* Relation of Emergency Contact Person to Student *

—Please choose an option—配偶 Spouse子女 children其他親戚或朋友 Other relative or Friend

緊急聯絡電話號碼 * Emergency Contact Phone Number

Please review all information prior submitting (在提交之前，請確認所有信息都正確）

Yes, information is accurate， Please check (是的， 所有信息都正确， 请点击=>）

學生英文名字* Student English First Name

學生英文姓氏* Student English Last Name

出生日期* Birth date

Choose Chinese Class (選擇中文課程）

--Choose Chinese class (請選擇中文課)--Adult Beginner-0(成人初級中文-0)-Sat. 12:30-2:20pmAdult Beginner-1(成人初級中文-1)-Sat. 9:30-11:20amAdult Beginner-2(成人初級中文-2)-Sat. 12:30-2:20pmAdult Intermediate (成人中級中文)-Sat. 9:30 –11:20am

Choose Leisure Class (選擇才藝課程）

Zumba for Adult(成人舞蹈)-Sat. 2:00-3:00pmCalligraphy(書法课)-Sat.11:30-12:20pmPiano Lesson-T 25 mins (鋼琴課-T 25mins)-Sat.2:30-4:30pmPiano Lesson-2T 50 mins(鋼琴課-2T 50 mins)-Sat.2:30-4:30pm

Please review all information prior submitting (在提交之前，請確認所有信息都正確）

Yes, information is accurate， Please check (是的， 所有信息都正确， 请点击）