NORTHERN VIRGINIA CHINESE SCHOOL
Class offered at:  GEORGE C. MARSHALL HIGH SCHOOL
School Location: 7731 LEESBURG PIKE, FALLS CHURCH, VA 22043

 
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FAMILY DATA:

 
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SERIAL NO.

LAST NAME

FIRST NAME

CHINESE NAME

HOME PHONE#

OTHER PHONE#
 

1.

PARENT:

 
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2.

PARENT:

 
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GRADE

 
BIRTH DATE

3.

STUDENT:

 
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STUDENT:

 
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5.

STUDENT:

 
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ADDRESS                                                    CITY                    STATE        ZIP          

Email:  
                                                           
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SERIAL #
/NAME

PIN-YIN
/PHONICS

STUDENTS
/CONVERSATION

ADULTS
ACTIVITY

CHINESE CLASS
CLASS fee

ACTIVITY
($120)

SUBTOTAL
($50/$40)

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

TOTAL: ______________