庫菩提諾慈濟人文學校 2024-25 在校生報名表

庫菩提諾慈濟人文學校 2024-25 新生報名

Continuing Student -Registration date from March 30, 2024
新生／轉學生註冊開始：2024年3月30日開始至額滿為止（名額若滿將提早截止）

New and transfer student- Registration date from March 30, 2024, until registration is closed

在校生註冊開始：2024年3月30日開始

Instruction for 2024-25 School Year Registration

https://drive.google.com/file/d/1C07uHyGW7njwjFZv2a8tyN7PYqqsjgoY/view?usp=share_link

PARTICIPANT RELEASE AND WAIVER OF LIABILITY (Please Download0

https://drive.google.com/file/d/1iLvLWB-RdUfp3P_dKFw_mQ5OuRzpi2YY/view?usp=share_link
新生學年度(2024-25)報名年級 Register Grade
插班考日期 *
注音班(K)以上之插班生均須通過考試，依成績錄取，本校將於學生完成報名手續之後，通知家長安排插班考試，詳細規定請參考本須知中第五項「插班須知
學生中文姓名 Student Chinese Name*

First NameLast Name
學生英文姓名 Student English Nam*

First NameLast Name
Date of Birth*

MonthDayYear
Date
性別 Gender*

男 Male女 Femal
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
地址 Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
父親英文姓名 Father English Name*

First NameLast Name
母親英文姓名 Mother English Name (First, Last)*

First NameLast Name
住家電話 Home Phone*
Please enter a valid phone number.
主要聯絡人 Main Contact*

父親 Father母親 Mother其他監護人 Guardian
主要聯絡人電話 Primary Phone*
Please enter a valid phone number.
主要聯絡人電子郵件信箱 Email Address*
example@example.com

其他子女就讀本校 Sibling Name (Name & Class 2023-24)

	Name	Grade
第一位
第二位
第三位
第四位

學校規則以及學生緊急聯絡人資訊
學生必須穿著印有慈濟人文學校之制服，深藍色褲及白色布鞋 Students must wear their Tzu Chi uniforms (dark blue pants and white shoes)*

Agree
學年度內家長至少參加六次學校人文活動 Parents must attend Ren Wen activities at least six times*

Agree
就醫授權書 Emergency Contact
Emergency Contact Name 1*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Emergency Contact Name 2*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
學年費 (Check Title: Tzu Chi Academy, Cupertino)

學年費用: 在校生$545(內含報名費$20,教材費用$25,學費$500)
新生 $575（含報名費$50,教材費用$25,學費$500）
制服費用: 冬季長袖一件$25, 夏季短袖一件$20
是否購買制服 is there a need to purchase a uniform?*

是不是
制服（制服尺寸請至辦公室參考樣品 please go to the office to look at sizes*

夏季制服x1 $20冬季制服x1 $25夏季制服+冬季制服- 各1 $45不用制服
支票號碼 Check # (Check Title: Tzu Chi Academy, Cupertino)*
支票備註欄請寫學生姓名及現在班級（Please write down your child's name and class at check memo)
支票金額 Check Amount $ - 在校生$545(內含報名費$20,教材費用$25,學費$500)*
若購買制服，請加上制服費用
為了讓學校多瞭解您的孩子，請回答下列問題：

In order to know your child a bit more, please answer the questions below:
Any Allergies or Medical Conditions?*

YesNo
Please give details (enter N/A if not applicable)*
Any health issues? (Asthma, Heart Attack or others?*

YesNo
Please give details (enter N/A if not applicable)*
Name of Physician/Pediatrician*

First NameLast Name
Phone Number*
Please enter a valid phone number.
我已詳閱並同意註冊須知https://docs.google.com/document/d/12u-Osipek72PUDfDf1CLSabuqvPN6HOYK9OJO4YexQE/edit?usp=sharing*

Agree
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance*

Agree
Please upload signed forms *PARTICIPANT RELEASE AND WAIVER OF LIABILITY FORM *

https://drive.google.com/file/d/1w7OmPSwcFo3WQk_JX8r6J2P6JdtPTR3a/view?usp=sharing
Cancelof
I, undersigned, agree with the following statements:*

I am the parent/guardian of the child indicated above.
Date*

MonthDayYear
Date
Signature*

Clear
Should be Empty:

學校規則以及學生緊急聯絡人資訊

就醫授權書 Emergency Contact

為了讓學校多瞭解您的孩子，請回答下列問題：