New Student Information Registration Page

Dialect Zone International Student Information Form

Dear Dialect Zone Staff Member:

Below, you will see the student information form, that can be filled out online in which will sent electronically.


Dialect Zone International Team




    Student’s English Name: (Optional - 可不填)

    Student’s Chinese Name: 学生中文名字

    Student's Chinese Name Pin Yin: 拼音

    Mother's Chinese Name: 家长中文名字 - 妈妈

    Mother's E-mail Address: 家长常用邮箱 - 妈妈

    Mother's Phone Number: 家长手机号 - 妈妈

    Father's Chinese Name: 家长中文名字 - 爸爸

    Father's E-mail Address: 家长备用邮箱 - 爸爸

    Father's Phone Number: 家长手机号 - 爸爸

    Student's Sex/Gender: 男孩 / 女孩


    Student's Age: 学生年龄 (实际年龄)

    Student's Date of Birth: 学生出生日期

    Mother's WeChat ID: 家长微信号

    Father's WeChat ID: 家长微信号

    Referred by: 介绍人

    Student's ID Card Number:

    Student's Clock Number:

    Student Form Image Front - 表格正面:

    Student Form Image Back - 表格反面:

    Start Date: 开始日期

    Emergency Contact - Chinese Name: 紧急情况下联系人(中文名)

    Emergency Contact’s Contact Number: 紧急情况下联系号码

    Does Child Have Any Special Needs: 孩子是否有其他特殊需求

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