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DECLARATION声明

I hereby agree 
本人特此同意:

For my child to be assessed for a place at EL-GENESIS Kindergarten。
我希望我的孩子能被评估进入伊莱瑞德双语幼儿园。

That this application does not guarantee my child a place at EL-GENESIS Kindergarten。
此申请表并不保证我的孩子在双语幼儿园有一席之地。

To provide a copy of my child's most recent kindergarten report, if any in English, at the time of assessment。
评估时将提供孩子近期的幼儿园住宿记录,并用英语填写。

To make all due payments in accordance with EL-GENESIS 's schedule of fees。
按照伊莱瑞德双语幼儿园的课程表支付所有费用。

To give in writing at least ONE TERM'S notice if my child is leaving the kindergarten。
如果我的孩子离开幼儿园,至少提前一个学期以书面形式通知园方。

I agree to official photographs of or quotes attributed to my child appearing in promotional material for EL-GENESIS Kindergarten。
本人同意孩子的照片肖像可能出现在伊莱瑞德双语幼儿园的招生宣传材料中。

I agree to abide by the admissions procedures of EL-GENESIS Kindergarten. I certify that the information given on this form is full and complete to the best of my knowledge and understanding。
本人同意遵守伊莱瑞德双语幼儿园的入学程序并保证申请表中信息完整无误。

If I fail to provide accurate details of important information about the applicant, the school reserves the right to restrict entry into or withdraw the applicant's place。
如本人未真实提供申请人的重要信息,伊莱瑞德双语幼儿园有权限制入学或退学。 

I also understand that the completed application must be accompanied by the full payment of the non-refundable application fee of RMB2,000(non-refundable)。
我也确知报名手续仅在交付报名费人民币 2,000 元(不可退还)之后生效。

SIGNATURE OF PARENT/GUARDIAN父母/监护人签名

Print Name

姓名

Signature

签名

Date

日期

REQUIRED DOCUMENTS FOR ADMISSION 入学所需文件

Please confirm all the listed items below are submitted with the application:
请确认以下所列项目均以提交申请

Copy of child's passport or mainland travel permit (HK. Macau, Taiwan)

子女护照或港澳通行证(香港,澳门,台湾)复印件

Copy of parent's Passport or mainland travel permit (HK.Macau,Taiwan)

父母护照或港澳通行证(香港,澳门,台湾)复印件

Copy of child's birth certificate

子女出生证明复印件

Child's medical form/Immunizationg Record

子女医疗表格/免疫记录

Copy of most recent school reports(officially translated to English if any)  
近期的学校报告复印件(如有可能请用英语翻译)

1Xphotograph parent(s)

1张父母照片

1Xphotograph of child

1张子女照片

RMB2000 application fee

报名费人民币2000元

Additional Documents for China Nationals 中国籍子女另需提供以下文件

Copy of household registration

户口簿复印件

Copy of China Natuional ID card

中国身份证复印件

CHILD DETAILS  子女信息 

Chinese name 中文姓名

English name 英文姓名

Nickname 昵称

Nationality 国籍

Date of Birth (dd/mm/yy) 出生日期

Gender 性别

ID number(Chinese student only) 身份证(仅限中国籍)

Passport number or mainland travel permit number (HK,Macau,Taiwan) 护照/港澳通行证

Home Address in China 中国境内家庭地址

Residential Address 住宅地址

Current Kindergarten (If have not go to school before,please fill in "None") 之前就读幼儿园(如果没有就填“无”)

Garade/Year Level 年级

Native  language 第一语言

Second language 第二语言

MEDICAL INFORMATION 医疗健康信息

Please indicate if your child has a history of the following and please provide details as appropriate

请说明您的孩子是否有下列情况的历史,并请酌情提供详情

Eye(Circle L/R or both) 眼睛(左/右眼或双眼)

Ear(Circle L/R or both) 耳朵(左/右耳或双耳)

Asthma 哮喘 

Heart Disease 心脏病

Diabetes 糖尿病

Epilepsy/Seizures 癫痫/癫痫发作

Digestive Problems 消化问题 

Breathing Diffculties 呼吸障碍 

Surgery 外科手术

Head Injury/Concussion 头部损伤/脑震荡

Convulsions 抽搐证

Allergies 过敏

Food /Drug Allergies 食物/药物补充剂

Others 其它 

Special Diet 特殊饮食

Vegetarian Diet

Halal meal (Muslim food)

Non-nut Diet

No

Please list any medication that youer child must take while at kindergarten indicating the dosage and timing

请列出您孩子在幼儿园期间必须服用的药物,并注明剂量和时间

PHYSICAL,EMOTIONAL,BEHAVIORAL & LEARNING ISSUES 身体,情绪,行为和学习问题 

Please indicate if your child has a history of the following and please provide details as appropriate  

请说明您的孩子是否有下列情况的历史,并请酌情提供详情

Hearing 听力

Vision 视力

Mobility

Speech 语言表达能力

Behavioural 行为能力

Learning 学习能力

Doctor's Name in China (if available)  中国境内医生姓名

Doctor's Phone number (if available) 医生手机

Clinic Name and Adress 医师诊所名字和地址

PARENT DETAILS 父母详情

Title 称谓

Firstname 名 

Surname 姓

Telephone 电话 

E-mail Address 邮件地址 

We chat 微信号

Home Address in China 家庭地址

Relationship to child 关系

Occupation 职业

Company Name 公司名称

Company Address 公司地址

GUARDIAN DETAILS 监护人详情 (if different from parent)

Title 称谓

Firstname 名 

Surname 姓

Telephone 电话 

E-mail Address 邮件地址 

We chat 微信号

Home Address in China 家庭地址

Relationship to child 关系

Occupation 职业

Company Name 公司名称

Company Address 公司地址

PAYMENT DETAILS 付款详情

Kindergarten tuition fees paid by
幼儿园学费支付者

Employer 雇主

Family 家庭

Both 都是

(If both,Please state % split)
如果都是请提供比例

Would you like invoices sent to your China Home Adress?
您是否需要发票寄往中国家庭地址?

Yes

No

(If no, please provide the alternativeaddress)

如果不需要,请提供其它选择地址

GENERAL INFORMATION  其它信息 

Relocation Agency 介绍人

Have You Visited EL Genesis Before? 是否曾经来访过

How did you hear about EL Genesis? (Check all that apply) 从何处获取信息

Friend 朋友

Relative 亲戚

Website 网络

Advertisement 广告

Know a family enrolled 有朋友孩子在本园

Another school 其他学校

Other 其它