Registration

十峰中文學校2007-2008年度報名表

Dix Hills Chinese Cultural Association Registration Form

DHCCA, P.O.Box 1344, Melville, NY 11747

學生資料 Student Information

姓名 Name		出生日期 Date of Birth	性別 Sex	新生? New Student?	文化課 Culture Class
中文 Chinese	英文 English	出生日期 Date of Birth	性別 Sex	新生? New Student?	文化課 Culture Class

文化課項目 Culture Class: 1. 功夫 Kung Fu 2. 民族舞蹈 Chinese Folk Dances 3. 中國象棋 Chinese Chess4. 國畫 Chinese Painting 5. 美勞 Arts and Crafts 6. 素描 Sketch 7.扯鈴Chinese Yo Yo 8.樂隊 Band

家庭資料 Family Information

父母或監護人 Parent/Guardian	姓名 Name		職業 Occupation	工作電話 Daytime Phone
父母或監護人 Parent/Guardian	中文 Chinese	英文 English	職業 Occupation	工作電話 Daytime Phone
父親 Father
母親 Mother
監護Guardian

住址 Address: ___________________________________________________________________

家庭電話 Home Phone (____)-______________手機 Cell Phone (____)-___________________

E-mail: ___________________________________________________________

緊急聯絡人(家長除外) Emergency Contact (Other than Parent/Guardian):

中文姓名____________ English Name ____________ 電話 Phone (____)-___________________

家庭裡最主要使用的語言或方言 Primary family language or dialect:

普通話 Mandarin ____廣東話 Cantonese _____英文 English_____ 其他 Other ___________

學費 Tuition: $315

註冊費 Registration Fee: $10

書費 Textbook: $20

家長會費 PTA Due: $10.00

值班按金 Safety Patrol Deposit: $20/per family (值班當天退還Will be refunded after fulfilling Safety Patrol Duty).

支票抬頭: DHCCA. Check payable to DHCCA

总費用Total Fees: $375.00 (或$365.00 六月二十日前註冊可免交書費。Registration fee waived if registered before June 20.)

自由捐款 (Donation) $10____ $20____ $50____ $100_____其它 (Other amounts)$______________

所捐款項可免稅 Donations are tax deductible.

是否有興趣參與如下工作 Would you be interested in joining us?

        校務工作 Volunteering in administrative work? _____

        教授語文課 Applying to teach language classes? _____

        教授文化課 Applying to teach cultural classes? _____

        家長代表 Being a class parent _____

     意見和建議 Comments and suggestions

____________________________________________________________________

____________________________________________________________________

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十峰中文學校收費表

DHCCA Charge List

項目 Item	收費 Amount	折扣 Discount	退欵 Refund	備注Remark
學費 Tuition	$315	15% teacher 10% 4^th child up	75% within 2 weeks. 60% within 4 weeks. No refund after 4 weeks	1,3
註冊費 Registration	$10	無折扣No discount	恕不退欵Not refundable
書費 Textbook	$20	無折扣No discount	恕不退欵Not refundable	2
練習本 Excise Book	Free	Not Applicable	Not Applicable	4
家長會費 PTA Due	$10	無折扣No discount	開學後恕不退欵 Not refundable after school starts.
值班按金 Safety Patrol Deposit	$20	無折扣No discount	值班當天或退學將退還Will be refund after fulfilling Safety Patrol Duty or withdraw

1 在開學一個月後入學的學生, 可享有回扣。Students enrolled after the first month pay only a partial fee based on time of enrollment. See below.

2 六月二十日前註冊可免交書費。Registration fee waived if registered before June 20.

3 每個新學生均可試讀兩星期。Every new student is entitled to a trial period of two weeks.

4 學校免費給予每個學生兩本練習本。如有需要多於兩本, 可向學校購買。每本售價$2.00。The school supplies each student 2 exercise books free of charge. If the student needs more, a charge of $2.00 each will be applied.

Partial fee based on time of enrollment :

October: $323.5 per student	March: $166 per student
November: $292 per student	April: $134.5 per student
December: $260.5 per student	May: $103 per student
January: $229 per student	June: $71.5 per student
February: $197.5 per student	Add $20 per family

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