小学生入学申请书范本

studentname:________________________中文姓名:_______________

grade年级:_______sex性别:_____phone电话:__________________

dateofbirth出生日期:________________(月日年)age年龄:_____

placeofbirth出生地:____________________________

address住址:__________________________________________________________

mother'sname母亲姓名:_____________________________occupation职业:_________________

workphone公司电话:_____________________homephone住家电话:_________________

address住址:________________________________________________________________________

father'sname父亲姓名:______________________________occupation职业:_________________

workphone公司电话:_____________________homephone住家电话:_________________

address住址:________________________________________________________________________

childliveswith学童和谁住在一起:1)mother母____2)father父____3)guardian监护人____(pleasestateguardian'sname,relationshiptochildandreasonchildhasaguardian.请注明监护人之姓名,与学童之关系及需要监护人之理由.)

dothegrandparentsliveinthefamilyhomewiththechild祖父母是否与学童住在一起_______

numberofbrothers兄弟人数______ages年龄______________

numberofsisters姊妹人数______ages年龄______________

howmanysiblingsdoesthechildlivetogetherwith与学童住在一起之兄弟姊妹有多少位_______

religiousfaithofparents父母之宗教信仰:______________________

doeschildembracethatfaith学童是否也信仰该宗教___________

aretheprinciplesofreligiondiscussedinthedailylifeofthefamily是否要求学童遵循该教之教义_____

hasthechildhadanybuddhistinstruction学童有否受过任何佛学教育__________________

ifso,underwhom从谁受教____________________________

doesthefamily(includingchild)attendreligiousservices学童与家人参加宗教仪式有多频繁

daily每天weekly每周occasionally偶而infrequently很少_______

educationhistory就学经历

doeschildspeakenglishfluently学童能否说流利的英语______

otherlanguages其他语言_______________________________________________________

speciallearninggifts学习特长:___________________________________________________

learningdisabilities学习障碍:____________________________________________________

specialeducationprogramsparticipatedin参与过之特殊教育:__________________________

previousschoolsattended曾就读过之学校

school

校名

address

校址

datesattended

就读日期共2页，当前12

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