Silent War Film Screening at Triangle Chinese School Registeration Form

Schedule 活动安排：
9:15-9:30am: Pre-screening chat with Alan Z with event participants
与艾伦・Z 及活动参与者进行会前沟通
9:30-9:40 Introduction about WAVES, Film and Guests.
介绍 WAVES 项目、影片及到场嘉宾
9:40-11:00: Film Screening
影片放映
11:00-11:30: Panel discussion and Q&A
专题座谈与问答环节

Name 名字*

First NameLast Name

Email 邮箱*

example@example.com

来参加的人数有多少？（包括你自己）How many people will be attending? (Including yourself)*

您的身份是：（可多选）Your role/identity is: (You may select more than one)*

您是通过哪些渠道了解到本次活动的？How did you hear about this event?*

是什么吸引您报名参加本次活动？（可多选）What attracted you to register for this event? (You may select more than one)*

亚裔心理健康议题 Asian American Mental Health Topic与青少年和家长的现场对话 Conversation with teenagers and parents嘉宾的分享 Guests talk and sharing社区支持与连接 Community Support and Connection想要更好地支持孩子的心理健康 Want to better support children's mental healthOther

您的语言水平：Your Language Level*

英文母语 Native English Speaker流利英文 Fluent in English英文水平有限 Have Limited English speaking不说英文 Don't speak any EnglishOther

你有什么想问嘉宾的问题？Do you have any questions for the panelists?

活动期间可能会进行照片拍摄，用于活动记录与非商业宣传，请确认您的同意。Photos may be taken during the event for documentation and non-commerical promotional purposes. Please confirm your consent.*

我同意本人及/或所携带未成年人在活动中被拍摄的相关照片，I consent to the use of photographs taken of me and/or any minor(s) accompanying me during the event我不同意被拍摄或用于宣传。（工作人员将尽量避免拍摄）I do not consent to being photographed or to the use of my image for promotional purposes. (Staff will make reasonable efforts to avoid photographing.)

	Strongly Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Strongly Agree
I feel comfortable interacting with someone who has experienced mental illness
I would feel comfortable seeking help if I were experiencing mental health problems
I am more likely to talk about mental health challenges with others

《沉默的战争》观影会报名表 Registration Form