Northern Virginia Chinese School

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Pleasae select registration form. (锟斤拷选锟斤拷注锟斤拷锟斤拷锟�)
	English Form	Chinese Form

NORTHERN VIRGINIA CHINESE SCHOOL Class offered at: GEORGE C. MARSHALL HIGH SCHOOL School Location: 7731 LEESBURG PIKE, FALLS CHURCH, VA 22043						锟斤拷office use 锟斤拷check #: 锟斤拷cash $: 锟斤拷date: 锟斤拷
FAMILY DATA:		Please fill every line carefully
SERIAL NO.		LAST NAME	FIRST NAME	CHINESE NAME	HOME PHONE#	OTHER PHONE#
锟斤拷	锟斤拷	锟斤拷	锟斤拷	锟斤拷	锟斤拷	锟斤拷
1.	PARENT:	______________	______________	______________	_______________	________________
2.	PARENT:	______________	______________	______________	_______________	________________
					GRADE	BIRTH DATE
3.	STUDENT:	______________	______________	______________	_______________	________________
4.	STUDENT:	______________	______________	______________	_______________	________________
5.	STUDENT:	______________	______________	______________	_______________	________________


ADDRESS CITY STATE ZIP Email: 锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷
SERIAL # /NAME	PIN-YIN /PHONICS	STUDENTS /CONVERSATION	ADULTS ACTIVITY	CHINESE CLASS CLASS fee	ACTIVITY ($120)	SUBTOTAL ($50/$40)

______________	______________	______________	______________	$______________	$______________	$______________
______________	______________	______________	______________	$______________	$______________	$______________
______________	______________	______________	______________	$______________	$______________	$______________
______________	______________	______________	______________	$______________	$______________	$______________

Cultural Activities Fee $10 + Registration Fee $ 10 ( per family ) = $ 20__

TOTAL: ______________

Chinese: 2:00 - 4:00	Adults Tai-Chi: 2:30 - 3:30	Kids Kung Fu: 4:00 - 5:00
Kids Folk Dance: 4:00 - 5:00	Adults Tennis: 2:30 - 3:30	Kids Tennis: 4:00 - 5:00
Kids Karate: 4:00 - 5:00	Kids Yo-Yo: 4:00 - 5:00	Kids Painting: 4:00 - 5:00

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Chinese: $120	Adults Tai-Chi(10 Classes): $50	Kids Kung Fu(10 Classes): $50
Kids Folk Dance (10 Classes): $50	Adults Tennis (8 Classes):$50	Kids Tennis (8 Classes): $40
Kids Karate (10 Classes): $50	Kids Yo-Yo (10 Classes): $50	Kids Painting (10 Classes): $50

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Please make check payable to NVCS	OR	Submit this form to Mr. James Jou at school on Sundays after school starts
Mail To: NVCS/Registration c/o: Mr. James Jou 5224 Fernbrook Drive, Centreville, VA 20120	\| \| \| \|

If you need more information please contact: Mr. James Jou (703) 815-9323 (Home); Ms. Jeanny Shu Ho (703) 626-3122 (Cell)

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注锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷 James Jou (703) 815-9323 | 锟斤拷校锟斤拷锟斤拷叶锟斤拷 Helen Chao (703) 625-8723 | 校锟斤拷锟斤拷锟斤拷锟斤拷 Jeanny Ho (703) 626-3122