网上注册 - SUMMER CAMP(夏令营) 2011

* 请完整填写以下信息进行注册。注册完成后，请将注册信息打印，并同健康表及支票一同寄交本中心。

  * Registration : $25.00 non-refundable fee is required of each child at registration time, due with the enrollment form.

  * Donations Optional: Facility Project Fund (Suggested $25) for Backpack / Record DVD / Souvenir picture.

  * Duration: At least 5 weeks of Summer session need to be registered.

Student's Information
First Name*
   Last Name*
   Chinese Name
  
     
Date of Birth(mm/dd/yyyy)*
   Gender*
Male  Female 		  Grade*
  
     
Home Address*
  
 
City*
   State
New Jersey 		  Zip*
  
       
Home Phone*
   Cell 1
   Cell 2
  
         
Email 1*
 Email 2
 
Mother/Guardian's Name*
 Father's Name
 
In case of Emergency, contact person*
 Relation
 
Contact Phone*
   Contact Cell
      
         
 
Session Days:desired(At least 5 weeks required)
Session Fee: $160.00/week Promotion Code(if available):
 
6/20~6/246/27~7/17/5~7/87/11~7/157/18~7/227/25~7/39
8/1~8/58/8~8/128/15~8/198/22~8/268/29~9/2

Skill Classes(Optional)
SAT
PSAT
Language
Music
Painting
Chess
Go
Martial Art
Dance

Other Information
Payment Agreement: • I hereby authorize ACS for the above payment for the ACS 2010 Program(s).