深圳维多利亚幼儿园VictoriaKindergartenShenzhen

Shanghai Victoria Kindergarten
2018-2019年度报名登记表Application Form
编号No：幼儿资料Applicant’s Information 请用正楷填写Please write in block capitals.
中文姓名Name in Chinese 英文姓名
Name in English
性别
Gender
出生日期Date of Birth 国籍Nationality
现居住住址Home Address 住址电话: Phone No.
证件类型Identification □身份证ID Card□通行证NRIC
□护照Passport
证件号码:
Identification #
户籍状态Household Registration 户口所在地
Nationality
□本市本区生
Resident of Shanghai
City and Local District
□本市非本区
Resident of Shanghai City
but Non-Local District
□外省市
Resident from other cities in
China
□香港Hong Kong □澳门Macau□台湾Taiwan□外籍Foreigner
现就读学校Current School:
●申请幼儿胞兄姊是否曾经/现正于本校就读
Has/Have the applicant’s sibling(s) studied/or are currently studying at a Victoria Kindergarten campus □否No□是Yes
胞兄姊姓名Name：就读年份Year(s) Attended：就读时班主任Class teacher：校舍Campus:
●申请人曾否报读本校? Has the applicant previously submitted applications to Victoria?
□否No □是Yes
申请年份Year applied 报读级别Class applied 申请校舍Campus applied
家长资料Parent’s Information
父亲Father 母亲Mother
姓名Name
国籍Nationality
最高学历及院校
Level of Education
And Name of Institution
职业/职务
Occupation/Position
就职单位Employer
电邮E-mail
移动电话Phone No.
照片Photo 照片
Shanghai Victoria Kindergarten
申請事項Application Details
级别Class (请于适当的空格内以√号表示选择 Please √the appropriate box to indicate your choice)
□小小班(Pre-K) 2015.9.1~2016.8.31出生之幼兒
Children who were born between 2015.9.1~2016.8.31.
□小班(K1) 2014.9.1~2015.8.31出生之幼兒
Children who were born between 2014.9.1~2015.8.31.
□中班(K2) 2013.9.1~2014.8.31出生之幼兒
Children who were born between 2013.9.1~2014.8.31.
学制Stream: 全日制双语国际班Whole Day International Bilingual Class
幼儿健康记录Child’s Health Record
曾有症状Medical History：
□高热惊厥Seizures □哮喘Asthma □心、肺疾病Cardiovascular/Pulmonary Disease
□血液病Blood Disease □习惯性脱臼Recurrent dislocation of joints □其它Others___________________是否食物过敏Any allergy to food?
□否No □是Yes 食物名称Name:_________过敏程度Allergic degree：□轻度Mild □中度Moderate □重度Severe
是否药物过敏Any allergy to Medicine？
□否No □是Yes 药物名称Medicine Name:____________
幼儿园资料收集声明Personal Information Collection Statement
本申请者所提交之个人资料，只会用作处理报读本机构之有关事宜。

All personal information collected will be used for application purposes only.
家长声明Parental Agreement
本人确认此申请表的信息完整准确，同意并遵守维多利亚幼儿园的入学程序。

如本人未准确提供申请人的入学信息，
维多利亚幼儿园有权不接受该入学申请。

In signing this application, I certify that the information I have provided is complete, accurate and given in full. I also agree to comply with Victoria Kindergarten’s admission procedure. If I have omitted important information or failed to complete the application in full, I understand and agree that Victoria Kindergarten reserves the right to restrict the applicant’s entry into the school.
家长签署Parent Signature: 日期Date：。