圣地亚哥华夏中文学校2021-2022学年春学期新生注册表

1. 此注册表仅供新生入学注册使用，在校生请至https://mycourses.sdhxcs.org登录注册。For new students only. Current students please log onto your student account at https://mycourses.sdhxcs.org and complete your self enrollment.

2. 请提供家长/监护人直接、有效联系方式，成人班学生可直接用本人作为联系方式 Please provide parent/guardian's most recently updated info and immediate contact. Adult program students may use yourself as contact.

家长/监护人英文姓名 Parent/Guardian English Name *

First Name Middle Name Last Name

家长/监护人中文姓名 Parent/Guardian Chinese Name

姓名

家庭住址 Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

家庭电话 Home Phone *

Area Code Phone Number

家长/监护人电子邮址 Parent/Guardian Email *

Confirmation Email

家长/监护人手机 Parent/Guardian Cell Phone *

Area Code Phone Number

3. 请提供学生注册信息 Please provide student information

Student English Name *

First Name Middle Name Last Name

学生中文姓名 Student Chinese Name

姓名

出生日期 Date of Birth *

Month Day Year

性别 Gender *

学生电子邮址 Student Email *

Confirmation Email

注册课程 Enrollment Programs *

本学年年级个人意愿 New student Preferred Grade in 2021-22

本学年上课时间个人意愿 Preferred Class Time in 2021-22 *

普通班一年级、三年级、四年级上午班，学分一上下午班，学分二、学分三上午班已满员

2021-22年所在学区 School District *

学校名称 School Name in 2021-22 *

所在年级 Grade Level in 2021-22 *

付款方式 Payment Methods *

Credit Card Payment 信用卡付款信息（Spring Semester 春学期) *

普通班 Regular Program + PTA + Service Deposit + Registration Fee $ 333.00

注意：普通班一年级、三年级、四年级上午班已满员

双语班 Bilingual Program + PTA + Service Deposit + Registration Fee $ 453.00

学分班 Credit Program + PTA + Service Deposit + Registration Fee $ 433.00

注意：学分一上下午班，学分二、学分三上午班已满员

学分双语班 Credit Bilingual Program + PTA + Service Deposit + Registration Fee $ 560.00

AP中文班 AP Program + PTA + Service Deposit + Registration Fee $ 615.00

注意：只有通过华夏AP分班考试的同学才有资格注册Only students have passed Hua Xia AP placement test are eligible to register

Total $ 0.00

Visa / MasterCard Payment
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

4. 请提供其它重要注册信息 Please provide other important information

紧急事故联络人 Emergency Contact Name *

联络人电话 Phone Number *

Area Code Phone Number

除家长外紧急事故联络人 Emergency Contact other than Parent *

除家长外联络人电话 Phone Number *

Area Code Phone Number

家庭医生姓名 Family Physician Name *

家庭医生电话 Phone Number *

Area Code Phone Number

医疗保险公司 Insurance Company *

保单号码 Policy Number *

5. 请仔细阅读各项条款，提交注册表后即视为接受本校规章制度 Please read Terms & Conditions. By click on "Submit", I acknowledge that I accept the Terms & Conditions.

Note:

- If you pay by credit card, an auto receipt will be sent to your email address. Please save and keep it till the end of the school year.

- If you wish to pay by Zelle, please send your payment to info@sdhxcs.org and note the student's English name and birthdate with the payment.

- If you wish to pay by check or money order, please print out the confirmation email and submit or mail a copy to school office along with your payment. Mailing address: 7920 Arjons Drive, Suite H, San Diego, CA 92126.

- We try our best to accommodate students' needs for the class time; however, students may be assigned to a class different than preferred due to class capacity and the student's language proficiency.

- Stop! Please Do NOT click "Submit" button more than once or go back to previous pages after submission as you may be double billed if you do so. This process may take up to a minute. If, after fill in all required information correctly and you still have trouble to submit, please contact us at info@sdhxcs.org.

Date

Month Day Year

Enter the message as it's shown *

圣地亚哥华夏中文学校2021-22学年春学期新生注册表