student name: ________________________ 中文姓名: _______________
grade年级: _______ sex性别: _____ phone电话: __________________
date of birth出生日期: ____ / ____ /________ (月/日/年) age年龄: _____
place of birth 出生地: ____________________________
address住址: __________________________________________________________
mother"s name母亲姓名: _____________________________ occupation职业: _________________
work phone公司电话: _____________________ home phone住家电话: _________________
address住址: ________________________________________________________________________
father"s name父亲姓名: ______________________________ occupation职业: _________________
work phone公司电话: _____________________ home phone住家电话: _________________
address住址: ________________________________________________________________________
child lives with学童和谁住在一起: 1) mother母 ____ 2) father父 ____ 3) guardian监护人 ____ (please state guardian"s name, relationship to child and reason child has a guardian. 请注明监护人之姓名, 与学童之关系及需要监护人之理由.)
do the grandparents live in the family home with the child祖父母是否与学童住在一起 _______
number of brothers兄弟人数 ______ ages年龄 ______________
number of sisters 姊妹人数 ______ ages年龄 ______________
how many siblings does the child live together with与学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学童是否也信仰该宗教 ___________
are the principles of religion discussed in the daily life of the family是否要求学童遵循该教之教义 _____
has the child had any buddhist instruction学童有否受过任何佛学教育 __________________
if so, under whom从谁受教 ____________________________
does the family (including child) attend religious services学童与家人参加宗教仪式有多频繁
daily每天 weekly每周 occasionally偶而 infrequently很少_______
education history 就学经历
does child speak english fluently 学童能否说流利的英语 ______
other languages其他语言 ______________________