小學(xué)入學(xué)英文申請書參考

　　student name: ________________________ 中文姓名: _______________

　　grade年級: _______ sex性別: _____ phone電話: __________________

　　date of birth出生日期: ____ / ____ /________ (月/日/年) age年齡: _____

　　place of birth 出生地: ____________________________

　　address住址: __________________________________________________________

　　mother's name母親姓名: _____________________________ occupation職業(yè): _________________

　　work phone公司電話: _____________________ home phone住家電話: _________________

　　address住址: ________________________________________________________________________

　　father's name父親姓名: ______________________________ occupation職業(yè): _________________

　　work phone公司電話: _____________________ home phone住家電話: _________________

　　address住址: ________________________________________________________________________

　　child lives with學(xué)童和誰住在一起: 1) mother母 ____ 2) father父 ____ 3) guardian監(jiān)護(hù)人 ____ (please state guardian's name, relationship to child and reason child has a guardian. 請注明監(jiān)護(hù)人之姓名, 與學(xué)童之關(guān)系及需要監(jiān)護(hù)人之理由.)

　　do the grandparents live in the family home with the child祖父母是否與學(xué)童住在一起 _______

　　number of brothers兄弟人數(shù) ______ ages年齡 ______________

　　number of sisters 姊妹人數(shù) ______ ages年齡 ______________

　　how many siblings does the child live together with與學(xué)童住在一起之兄弟姊妹有多少位 _______

　　religious faith of parents父母之宗教信仰: ______________________

　　does child embrace that faith學(xué)童是否也信仰該宗教 ___________

　　are the principles of religion discussed in the daily life of the family是否要求學(xué)童遵循該教之教義 _____

　　has the child had any buddhist instruction學(xué)童有否受過任何佛學(xué)教育 __________________

　　if so, under whom從誰受教 ____________________________

　　does the family (including child) attend religious services學(xué)童與家人參加宗教儀式有多頻繁

　　daily每天 weekly每周 occasionally偶而 infrequently很少_______

　　education history 就學(xué)經(jīng)歷

　　does child speak english fluently 學(xué)童能否說流利的英語 ______

　　other languages其他語言 _______________________________________________________

　　special learning gifts學(xué)習(xí)特長: ___________________________________________________

　　learning disabilities學(xué)習(xí)障礙: ____________________________________________________

　　special education programs participated in 參與過之特殊教育: __________________________

　　previous schools attended曾就讀過之學(xué)校

　　school

　　校名

　　address

　　校址

　　dates attended

　　就讀日期

　　reason for leaving/transfer

　　離校或轉(zhuǎn)學(xué)理由

　　cumulative record currently at which school 目前就讀之學(xué)校

　　school 校名

　　address 校址

　　phone電話

　　i hereby certify that all the information provided above is true, and all questions have been answered accurately, completely and to the best of my knowledge and ability. i realize that failure to do so can be grounds for non-acceptance and/or immediate dismissal.

　　茲保證以上所填資料均屬實(shí); 如有任何隱瞞不實(shí),將遭到不得入學(xué)或勒令退學(xué)之處分.

　　signatures of all legal guardians are required. 所有法定監(jiān)護(hù)人均須簽名.

　　parent signature x____________________________________ date日期 __________

　　父母簽名 x____________________________________ date日期 __________

　　references推薦人

　　please include below the names, addresses, and phone numbers of two references, one of which must be the child's most recent teacher. 二位推薦人中,至少須包括一位學(xué)童之現(xiàn)任教師.

　　name 姓名

　　address 住址

　　phone電話

　　if the child has any learning disabilities, handicaps (physical, mental, or emotional), or strong personality traits, please elaborate (use separate sheet if necessary.) 請?jiān)斒鰧W(xué)童之學(xué)習(xí)障礙及特殊個(gè)性(可另紙說明).

　　include on a separate sheet, a hand-written essay by the student as to why he/she wants to attend our school. please encourage the child to be frank and straight forward and to express his/her true feelings and aspirations in the own sentiments and words. (approximate length will vary from 100 to 500 words according to age.)

　　請學(xué)童另紙?jiān)斒鲇�就讀本校之理由; 長度視其年齡而定,限在一百至五百字之間.

　　educating for filiality, service, humaneness, and integrity

　　忠 孝 仁 義

　　please paste student's recent picture here.

　　學(xué)生近照黏貼處

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