2005 Chinese Summer Camp

Experience Fun Class and Life in China !

APPLICATION FORM

 

Personal Information

Name
Gender

Male    Female  

Birthday (dd/mm/yy)

 

Address

 

Home Phone

 

E-mail

 

Parents  

Father Mother
Name
Business Phone
Mobile Phone
E-mail
Employer

  

school

School Name
[FrontPage 保存结果 组件]

Grade
[FrontPage 保存结果 组件]

Address

 

Name of Principal 

[FrontPage 保存结果 组件]

Phone
[FrontPage 保存结果 组件]

Special Skills or Interests
[FrontPage 保存结果 组件]

Chinese Level   

Beginner

Medium

Fluent

Family Physician’s Name
[FrontPage 保存结果 组件]

Phone

[FrontPage 保存结果 组件]

Any health-related condition about which we should be aware

[FrontPage 保存结果 组件]

I wish to attend:

     Summer Tour and camp                  1 week     

    Summer Class training and Tour        2 weeks     

    Intensive Classes training and Tour   3 weeks   

    Intensive Classes training and Tour   4 weeks   

　 Date 

(dd/mm/yy)

 Print Name  Signature  

Applicant

　

                            

Parent or Guardian

(if student is younger than 18 years old) 

                            

                      

 Additional: 

How did you hear about us?       Newspaper        Poster        E-mail        Website  

Please complete the application form, print and sign it, then send it with the enclosed materials (photo and $200 deposit) to the following address:

JFWS Camp

16429 Hampton Chase

Strongsville , OH 44136