北大附中海口学校高中国际班入学申请

感谢您对北大附中海口学校高中国际班的关注，如需报名，请完成以下表格.
Thanks for your interests in PKUHS Haikou,International Division. For admission application, please fill the form below.
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1.
学生姓名 Full Name of Student
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2.
姓名拼音 Name in Pinyin
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3.
出生日期 Date of Birth
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4.
性别 Gender
男
女
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5.
监护人联系电话 Mobile Phone Number of Guardian
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6.
请选户籍所在地 Household Registration Location
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7.
学籍所在地 XUEJI Household Registration Location
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8.
国籍 Nationality
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9.
现在就读学校 Current School
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10.
现在就读年级Current Grade
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11.
初中段曾就读学校 School(s) Attended since Grade 7（若有海外就读经历请注明）
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12.
监护人姓名1 Name of Parent/Guardian 1
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13.
监护人1联系电话 Mobile Phone Number
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14.
监护人姓名2 Name of Parent/Guardian 2
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15.
监护人2联系电话 Mobile Phone Number
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16.
学生是否曾被要求停学或开除？Has the applicant been requested to leave a school?
是 Yes
否 No
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17.
学生是否曾有任何身体上的障碍，是否会影响他/她的学习，比如讲话，听力，视力或者严重的过敏？Does the applicant have any physical challenges that may affect his or her learning such as areas in speech, hearing, vision or severe allergies which may affect his/her learning?
是 Yes
否 No
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18.
学生是否在校内或校外接受过任何学习支持服务，比如身体上，教育上，行为上，职业上，讲话和成长上的支持？Has the applicant ever received any learning support services such as any kind of physical, educational, behavioral, occupational, speech, development support in or out of school?
是/否
是 Yes
否 No
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19.
学生是否曾需要用药物控制注意力，过度活跃或其他精神、情绪和行为？Has the applicant ever been prescribed medication for attention deficit, hyperactivity or other emotional needs?
是 Yes
否 No
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20.
您是从哪个渠道了解到我们学校的？How did you learn about our school?
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