2006  年插班在汇佳中文夏令营Summer Camper Application

             

CAMPER INFORMATION

First Name______________  M.I.___________

Last Name ________________________

中文姓名_________________________

Boy ____  Girl_____

Date of Birth        /        /             (MM/DD/YY)

Camper’s School 2005-06____________________________

Camper's Grade Completed BEFORE Summer '06___________

Camper's Mailing Address____________________________

City____________________ State_______ Zip_______

Home Phone (      )________________

Camper's E-mail Address_____________________________

Any Friend the camper want stay with together, please list his/her friend's name___________________________

Camper's Chinese language level(Please check all that apply):
Understand a little
Understand pretty well
Can not speak at all
Can speak a few words
Can speak proficiency
Can not read
Can read short stories
Can read middle size article
can read a newspaper
writing a few sentences
writing proficiency 

Please attach

your camper's

photo here.

  
 
Select Start Date:  
05/28/2006
06/11/2006
06/25/2006
07/09/2006
 

Select length:  

two weeks
four weeks
six weeks
eight weeks
     
FAMILY  INFORMATION
1st Parent/Guardian_____________________ Home Phone ( )_______
Address______________________________ Home Fax ( )________
City State Zip______________________________ Cell Phone ( )_______
Occupation & Employer_________________________ Business Phone ( )
E-mail Address_______________________________
2nd Parent/Guardian_____________________ Home Phone ( )_______
Address______________________________ Home Fax ( )________
City State Zip______________________________ Cell Phone ( )_______
Occupation & Employer_________________________ Business Phone ( )
E-mail Address_______________________________
ADDITIONAL INFORMATION

From whom did you learn about ACES Summer Camp?
Why did you pick ACES Summer Camp?
What are the camper's objectives?
What are the parents' objectives?
Do you suggest any special guidance?
 DEPOSIT INFORMATION

We requires a $300 deposit with this application, which we will apply toward the camp fee.

The remaining balance is due May 5, 2006. We will refund $150 of the deposit for all cancellations before May 5, 2006. We will make no refunds for cancellations after May 5, 2006.  

$100 deposit sibling discount for each additional camper from the same family

  

For office use only 

dep?        Y               N

 amt $_____ck #_____

date in : _________

office initials: ________

 
REQUIRED APPROVAL & SIGNATURE

I APPROVE this application and all conditions stated, and hereby certify that my child is of good moral character. 

Signature of Parent or Guardian_________________________ Date__________

Contact to ACES: 512-335-0620

Please make your check payble to: ACES and mail this application with your deposit to:

ACES

7505 Yaupon Dr.

Austin, TX 78759