申請表格(中文) 申請表格(中文) STUDENT INFORMATION 申请学生的基本资料Surname 姓 *Given Name 名字 *English Name 英文名 Gender 性别 *Female 女Male 男Date of Birth 出生日期 *(mm/dd /yy) (月月/日日/年年)Cellular Number 移动电话 *E-mail address / E-mail 邮箱 *Wechat # (if applicable) 微信號碼 (如有) Study Permit 学习签证 *I have 有I don’t have 没有Student Permit Expiry Date 学签过期日期 (mm /dd /yy) 月月/日日/年年PEN number (if applicable) / PEN 号码(如果已有) Current Local Address 目前居住地址 *Street Address 街道City 城市 *Province 省 *Country 国家 *Postal Code 邮编 * PARENT INFORMATION 学生父母的基本资料Father 父亲 *Family Name 姓 *Given Name 名字Mother 母亲 *Family Name 姓 *Given Name 名字Permanent Address (in Home Country) 长期居住地址 Street Address 街City 城市 *Province 省 *Country 国家 *Postal Code 邮编 *Parent's Cellular Phone 父母亲手机 *Home Telephone 家固定电话 *Parent's E-mail address 父母电子邮箱 * LIVING ARRANGEMENTS WHILE STUDYING AT CITY VANCOUVER ACADEMY 在温哥华城市学院就读期间的住宿安排Do you need homestay arrangements to be made by City Vancouver Academy?/ 请问您需要温哥华城市学院帮你安排寄宿家庭吗? *Yes 是No 否 (Students may only reside with parents, guardians, or in a homestay approved by City Vancouver Academy) (学生将只能居住于学生的家长,亲戚 或 温哥华城市学院合作的寄宿家庭) APPOINTMENT CUSTODIAN / GUARDIAN 监护人委托书Please choose one of the following / 请选择下列选项之一 *I request City Vancouver Academy to appoint custodian for my child. 我同意温哥华城市学院帮我孩子安排监护人.My child will live with the custodian of the following person who is a Canadian Citizen or landed immigrant and is over the age of 25. I can provide proof of legal custodianship. 我的孩子将会和以下的监护人(加拿大 25 岁以上成年本地公民/居民)一起居住. 我能夠證明擁有合法監護人.Family Name 姓 First Name 名字 Relationship 关系 Address Street Address 街City 城市 Province 省 Country 国家 Postal Code 邮编 E-mail address / E-mail 邮箱 Phone (Home) 电话(家庭) Phone (Business) 电话 (工作/手机) EMERGENCY CONTACT 紧急联系人Who is your emergency contact? *誰是你的緊急聯繫人Parents 父母Appointed Custodian/Guardian 法定監護人If neither of the above, listed below 如非上述兩種, 請說明Family Name 姓 Given Name 名字 Street Address 街 City 城市 Province 省 Country 国家 Postal Code 邮编 E-mail / E-mail 邮箱 Phone 电话 EDUCATION HISTORY 受教育经验Name and location of most recent schools attended 请填写最近几年申请学生所就读过的学校名称以及地址School 学校名称 *City, Country 市,国家 *Date Attended 就读日期 *Grades(s) Completed 就读过的年级 *School 学校名称 City, Country 市,国家 Date Attended 就读日期 Grades(s) Completed 就读过的年级 PARENT CONSENT 家长同意条例Field Trips 校外旅行 *I give my child permission to attend school education program-sponsored field trips. 我同意让我的孩子去参加学校组织的有教育意义的校外旅行.Yes 是No 否Release of Information 信息发布 *I give permission for my child’s name, photograph and video to be used as it related to the production of a school play or concert, a school event or promotion of City Vancouver Academy. 我同意给温哥华城市学院使用含有我孩子的名字 或 人物照片 或视频等能用于学校的活动或音乐会以及学校的宣传. (同意自 己的孩子名字或者相片可能会出现在学校的宣传册,网站或者学校组织的活动)Yes 是No 否 HEALTH INFORMATION 健康状况 Basic health coverage is available to students through the BC Medical Services Plan (MSP) after three months of landing in Vancouver, Canada. Students should buy private medical insurance for at least the first 6 months while in Vancouver, Canada. 所有有特殊需求的学生,必须在申请签证前进行健康评估。基本医疗保险是学生在购买卑诗省医疗服务计划(MSP)后并在登 录加拿大温哥华三个月后,方开始生效。學生首次登陸溫哥華時, 需要向私人保險機構購買至少6個月有效的醫療保險.If student is already studying in BC, please provide Care Card number / 如果学生已在 BC 省内读书, 请填写您的医疗卡的号码 Does the student have any medical condition (including severe allergies) or take any medication? *请问学生有任何健康状况(包括严重性过敏)或正在服用什么药物吗?Yes 是No 否If YES, please describe / 如果有,请说明 Does the student have a perceived or documented learning disability, physical handicap, social integration difficulty, behavioural concern or history of criminal behaviour? *学生是否有,被察觉或被书面告知学习障碍,肢体伤残,融入社会困难,行为问题或曾经有犯罪行为?Yes 是No 否If YES, please describe / 如果有,请说明: Name of Family Doctor 家庭医生姓名 Phone 电话 City/Country 城市/国家 SURVEY 问卷调查How did you hear about City Vancouver Academy? 请问您是通过以下什么方式知道温哥华城市学院? *Friend/Relative 朋友/亲戚Newspaper/Magazine 报纸/杂志 报刊名School Website 学校网站Internet (e.g. Google Search) 上网 (e.g. Google, 百度)Agent / Agency / School 中介公司(人)/学校Other/ 其他If it was through a Newspaper, Magazine, or Other, please provide the name AGENCY/AGENT/SCHOOL 推荐人/中介公司/学校Name of Agent/Agency/School 中介人/中介公司/学校 Contact Person 联系人 Business Telephone 办公电话 E-mail address 电子邮箱 Address Street Address 街Province 省 Country 国家 Postal Code 邮编 IMPORTANT INFORMATIONCHECKLIST 资料列表 *Admission Application Form / 入学申请表$200.00 application fee (non-refundable) / $200.00 申请费 (不可退还)Original or certified English translated transcripts for past 2 school years / 过去 2 个学年的英文版公证的成绩单或者原件Clear photocopy of passport, driver's license or BC ID / 本人護照, 駕照或BC ID的清晰複印件Clear photocopy of custodian declaration (IMM5646) / 法定監護人公證書 (IMM5646表格) 的清晰複印件Clear photocopy of parent/guardian/custodian ID with photo and address / 有照片及地址的父母或監護人證件的清晰複印件Clear photocopy of Care Card or other medical insurance (valid for 6 months) / BC醫療保險卡或其他機構之醫療保險證明的清晰複印件 (有效期至少6個月)DISCLAIMER 免責聲明 *A) This application does not automatically admit the applicant to City Vancouver Academy. Admissions depend upon the number of places available, test, academic transcripts, and validity of legal documents. 本申請表不能保證申請人被溫哥華城市學院的錄取. 錄取與否需根據報讀班級名額, 入學考試成績, 過去在校成績以及所需文件是否完整進行綜合評定. B) The applicant certifies that all information provided on this application is true and accurate. 申請人保證其所提供的所有信息是真實準確的. C) Should the applicant be admitted, the student and his/her parents or guardians agree to support the rules and values of the school and Code of Conduct. 學生一經錄取, 其本人并其父母或監護人同意遵守本校的各項規章制度及守則. D) Enrolment is for the full academic year, if a parent withdraws a student mid-year they are responsible for the full year’s tuition. 我校以一學年為時間段錄取學生, 如發生中途退學, 學生及家長需對所交/應交學費負責. E) Payment deadline is generally two weeks prior to the first day of class. Any outstanding account balance after the payment deadline is subject to a late payment charge of $20 per day. 學費繳費截止日期通常為新學期開學日之前的兩個星期. 截止日期后繳費(包括之前未能全額支付學費)的學生, 需要支付每天$20加幣的滯納金. F) By paying the tuition, the student agrees that he or she has and will provide all supporting documents necessary to study in City Vancouver Academy and Canada legally. 學生一旦支付學費, 即表示其同意提供溫哥華城市學院及加拿大政府相關機構所要求的各項文件, 以保障其在加拿大學習之合法性. REFUND POLICY FOR STUDENTS NEW TO CITY VANCOUVER ACADEMY 退款政策(给新生) City Vancouver Academy (the school authority) must post financial guarantees no less than $100, 000 in accordance with the Bonding Act. As a bonded school, City Vancouver Academy provides peace of mind for parents and students, who are guaranteed that their tuition fees are safe and a full education will be provided to each and every student. 其他情况的学生例如成为着加拿大居民前交的学费是没有阐述在上面的退款政策。温哥华城市学院(校方)必 须按照法律不低于$ 100,000来做担保。作为一个私立学校,温哥华城市学院为家长提供安心为家长和学生,谁 是保证他们的学费是安全的和完整的教育将提供给每一个学生 温哥华城市学院承诺提供最完善的教育给每一 位学生。I understand and agree to these Terms and Conditions VERIFICATION 驗證碼Please enter any two digits 請輸入任意兩個數字 *Example 例如: 12This box is for spam protection - please leave it blank:
