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Chess
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Wordly Wise 3000
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Adult English Course
US Citizenship Test
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Home
Enrichment Program
Chess
English ESL
Public Speaking
Reading & Writing
Singapore Math
Social Studies
Spanish
Wordly Wise 3000
Adult Learning
Adult English Course
US Citizenship Test
TEST PREP
OUR TEAM
CLASS SHOP
NEW CUSTOMER INFO SHEET
Student Name 1 / 学生姓名 1
*
First Name
Last Name
Student Date of Birth 1 / 学生生日 1
*
MM
DD
YYYY
Student Age 1 / 学生年龄 1
*
Student Gender 1 / 学生性别 1
*
Female / 女
Male / 男
Student Name 2 / 学生姓名 2
First Name
Last Name
Student Date of Birth 2 / 学生生日 2
MM
DD
YYYY
Student Age 2 / 学生年龄 2
Student Gender 2 / 学生性别 2
Female / 女
Male / 男
Contact Person / 联系人姓名
*
Parent's name
First Name
Last Name
Phone / 联系电话
*
(###)
###
####
Email
*
Address / 住址
City / 城市
*
Zip Code / 邮编
*
Customer Local Time Zone / 学生当地时区
*
EST / 美东
PST / 美西
CST / 美中
MST / 山地
Australia / 澳洲
China / 中国大陆
OTHER / 其它
Subjects / 学科
*
Art & Drawing
Chess
English
Reading & Writing
Singapore Math
Where do you hear from us? / 您从哪里了解到我们?
*
Google search/ Friend (朋友姓名或微信名) / etc.
Note / 您的微信名 / n.a. / etc.
*
Thank you!