UCA WAVES HEALTH EDUCATION SERIES 健康教育系列 2025 报名表

1
Which location of the WAVES HEALTH EDUCATION SERIES are you interested in?您对哪个地点的 WAVES 健康教育系列活动感兴趣？* This field is required.
Chapel Hill (Chinese, 中文)
Cary (Chinese, 中文)
Morrisville (English, 英语)
2
Email 电子信箱* This field is required.
example@example.com
3
WeChat ID (Optional)
4
What is your age group? (您的年龄段是什么)* This field is required.
20-30
30-40
40-50
50-60
above 60
5
If you are a parent, what is the age group of your child/chidden? (如果您是家长，您的孩子的年龄组是多少?
0-3 years (岁)
4-7 years (岁)
8-12 years (岁)
13 years- college (13 岁 -大学)
College age - 25 years (大学 - 25 岁)
over 25 years (超过25岁)
6
Are you a North Carolina Residence? 您是北卡罗来纳州居民吗？
YESNO
7
Are you a Wake County Residence? 您是威克郡居民吗?* This field is required.
YESNO
8
How did you hear about us? 您是怎么知道我们的？（multiple selections 可多选)
WAVES Village Parent Support WeChat Groups/WAVES 心理成长互助微信群
WAVES Newsletter/WAVES 简报
WAVES WeChat OfficialAccount/WAVES 公众号
WAVES Social Media/WAVES 社交媒体
Family or Friends/家人或朋友
Other
9
What are you interested in for future topics for WAVES HEALTH EDUCATION SERIES? 您对未来健康教育系列有哪些感兴趣的主题？（optional)
10
Do you agree to the confidentiality agreement and group expectations listed below? 您是否同意严格保密并遵守以下规则？* This field is required. 第一：严格遵守保密原则，禁止泄露小组成员的身份、个人信息和所分享的内容；第二：支持组的名额有限，一旦报名请务必尽量参加，如有特殊情况不能参加，请通知管理员；第三：高标准共同维护所有人的安全空间，尊重包容，正向沟通，同理接纳，互相倾听，不评判、不给不请自来的建议，积极参与讨论，共同学习成长。
YESNO
11
Name 姓名* This field is required.
First Name 名
Last Name 姓
Should be Empty: