student name: ________________________ 中文姓名: _______________
grade年級(jí): _______ sex性別: _____ phone電話: __________________
date of birth出生日期: ____ / ____ /________ (月/日/年) age年齡: _____
place of birth 出生地: ____________________________
address住址: __________________________________________________________
mother's name母親姓名: _____________________________ occupation職業(yè): _________________
work phone公司電話: _____________________ home phone住家電話: _________________
address住址: ________________________________________________________________________
father's name父親姓名: ______________________________ occupation職業(yè): _________________
work phone公司電話: _____________________ home phone住家電話: _________________
address住址: ________________________________________________________________________
child lives with學(xué)童和誰住在一起: 1) mother母 ____ 2) father父 ____ 3) guardian監(jiān)護(hù)人 ____ (please state guardian's name, relationship to child and reason child has a guardian. 請(qǐng)注明監(jiān)護(hù)人之姓名, 與學(xué)童之關(guān)系及需要監(jiān)護(hù)人之理由.)
do the grandparents live in the family home with the child祖父母是否與學(xué)童住在一起 _______
number of brothers兄弟人數(shù) ______ ages年齡 ______________
number of sisters 姊妹人數(shù) ______ ages年齡 ______________
how many siblings does the child live together with與學(xué)童住在一起之兄弟姊妹有多少位 _______
religious faith of parents父母之宗教信仰: ______________________
does child embrace that faith學(xué)童是否也信仰該宗教 ___________
are the principles of religion discussed in the daily life of the family是否要求學(xué)童遵循該教之教義 _____
has the child had any buddhist instruction學(xué)童有否受過任何佛學(xué)教育 __________________
if so, under whom從誰受教 ____________________________
does the family (including child) attend religious services學(xué)童與家人參加宗教儀式有多頻繁
daily每天 weekly每周 occasionally偶而 infrequently很少_______
education history 就學(xué)經(jīng)歷
does child speak english fluently 學(xué)童能否說流利的英語 ______
other languages其他語言 _______________________________________________________
special learning gifts學(xué)習(xí)特長(zhǎng): ___________________________________________________
learning disabilities學(xué)習(xí)障礙: ____________________________________________________
special education programs participated in 參與過之特殊教育: __________________________
previous schools attended曾就讀過之學(xué)校
school
校名
address
校址
dates attended
就讀日期
grade年級(jí): _______ sex性別: _____ phone電話: __________________
date of birth出生日期: ____ / ____ /________ (月/日/年) age年齡: _____
place of birth 出生地: ____________________________
address住址: __________________________________________________________
mother's name母親姓名: _____________________________ occupation職業(yè): _________________
work phone公司電話: _____________________ home phone住家電話: _________________
address住址: ________________________________________________________________________
father's name父親姓名: ______________________________ occupation職業(yè): _________________
work phone公司電話: _____________________ home phone住家電話: _________________
address住址: ________________________________________________________________________
child lives with學(xué)童和誰住在一起: 1) mother母 ____ 2) father父 ____ 3) guardian監(jiān)護(hù)人 ____ (please state guardian's name, relationship to child and reason child has a guardian. 請(qǐng)注明監(jiān)護(hù)人之姓名, 與學(xué)童之關(guān)系及需要監(jiān)護(hù)人之理由.)
do the grandparents live in the family home with the child祖父母是否與學(xué)童住在一起 _______
number of brothers兄弟人數(shù) ______ ages年齡 ______________
number of sisters 姊妹人數(shù) ______ ages年齡 ______________
how many siblings does the child live together with與學(xué)童住在一起之兄弟姊妹有多少位 _______
religious faith of parents父母之宗教信仰: ______________________
does child embrace that faith學(xué)童是否也信仰該宗教 ___________
are the principles of religion discussed in the daily life of the family是否要求學(xué)童遵循該教之教義 _____
has the child had any buddhist instruction學(xué)童有否受過任何佛學(xué)教育 __________________
if so, under whom從誰受教 ____________________________
does the family (including child) attend religious services學(xué)童與家人參加宗教儀式有多頻繁
daily每天 weekly每周 occasionally偶而 infrequently很少_______
education history 就學(xué)經(jīng)歷
does child speak english fluently 學(xué)童能否說流利的英語 ______
other languages其他語言 _______________________________________________________
special learning gifts學(xué)習(xí)特長(zhǎng): ___________________________________________________
learning disabilities學(xué)習(xí)障礙: ____________________________________________________
special education programs participated in 參與過之特殊教育: __________________________
previous schools attended曾就讀過之學(xué)校
school
校名
address
校址
dates attended
就讀日期