青少年在线中文课程报名表

Online Study Application Form for Kids and Teens

家长情况/Parent Information

称呼
Salutation/Prefix:
家长姓名
Parent Full Name:
家长电子邮件
Parent Email:
联系电话
Parent Phone Number:


学生信息/Student Information

姓名/Full Name:
中文名字(如果有)
Name in Chinese Characters
(if any):
年龄/Age: 性别/Gender: 男/Male女/Female



课时信息/Class Information

希望课程开始日期 / Expected Starting Date
希望每周上课次数 / Expected number of class every week:
1 课时/1 hour2 课时/2 hours3 课时/3 hours4 课时/4 hours5 课时/5 hours6 课时/6 hours
每周上课日期 / Expected date of class
周一/Monday周二/Tuesday周三/Wednesday周四/Thursday周五/Friday周六/Saturday周日/Sunday
购买课时数 / Number of classes to buy
20课时/20 hours40课时/40 hours80课时/80 hours100课时/100 hours120课时/120 hours



付款方式 / Payment Information

我们的课程顾问会根据您的付款方式提供给您我们的付款信息
Our course consultant will provide the payment information according to your payment method.
人民币银行转账/RMB Bank Transfer人民币支付宝转账/RMB Transfer via Alipay外币(美元)银行转账/Foreign Currency(US dollar) Bank Transfer外币(非美元)银行转账/Foreign Currency(Other than US dollar) Bank Transfer国际信用卡在线支付(+手续费4.4%)/Online payment by International Credit Card(+4.4% Fees)