You could download the registration form to fill it out and print it.

 

Dix Hills Chinese Cultural Association (DHCCA)
P.O. Box 1344, Melville, NY 11747        A Non-Profit Organization
Website: www.dhcca.org     Email: principal@dhcca.org
Chinese School Registration 11-12
Student Information:
(Must be born before 12/31/2007 for Pre-kindergardener, original birth certificate required)
Legal Name	Chinese Name	Date of Birth	Sex	New	Current
				Student?	Class #
Address	Town	Zip	Home Phone
Family Information:
	Father		Mother
Legal Name
Chinese Name
Email
Cell Phone
Family Language
Payment Information:
Total fees (including registration and textbooks):
$495.00/per student (Membership $200 and Tuition $295)
The membership fee can be used for gift matching program in your company.
Please use two separate checks for above fees.
Payable to: DHCCA and mail to: P.O. Box 1344, Melville, NY 11747
Class Place: HHH High School West at 375 Wolf Hill Road, Dix Hills, NY 11746
Class Hour:   7:00pm to 9:45pm Fridays (First day of school 9/9/11)
Parental Agreement:
I, the parent/guardian of my son/daughter give permission for them to participate in the Dix Hills Chinese Cultural Association's programs (not a HHH activity). I hereby waive, release, and agree to hold harmless the Dix Hills Chines Cultural Association, its officers, organization, teachers, participants, consultants, volunteers or the facility where the class is performed, from any claim arising from any injury or loss to my child (chrildren).
Signature of Parent/Guardian	Today's Date	Emergency Contact		Emergency Phone
Office Use Only:	Date	Check #	Cash	Amount