EmailMeForm
Oakland Asian Cultural Center
Adult Student Class & Workshop Registration Form (成人課程報名表)
**請用英文填寫報名表格**
Date Time (日期)
*
MM
/
DD
/
YYYY
Name (姓名)
*
First
Last
Gender (性別)
*
Male (男性)
Female (女性)
Ethnicity (種族)
*
Age (年齡)
*
Date of Birth (出生日期)
*
Address (地址)
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Phone (聯絡電話)
*
###
-
###
-
####
Email (電郵郵址)
*
Preferred Method of Communication (首選聯絡方式)
*
Email
Mail
Phone
Class Information (課程資訊)
Class (課程名稱)
*
Please select
Chinese Folk Dance
Chinese Guzheng (Zither)
Chinese Painting and Drawing
Erhu
Qi Gong
Qugin
Shaolin Gong Fu Adult
Shaolin Gong Fu Youth
Taiji Chen
Time (時間)
Day (星期幾)
Adult students shall hold all instructors & OACC harmless from any and all damages and injuries during classes and performances at all time. By typing your name below, you are agreeing to these terms.
General Policies:
* All classes are catered on a first come first serve basis.
* You must complete and sign workshop registration form to participate in any OACC class or workshop.
* If you miss a class, you may make it up (subject to class instructor's discretion) but no refund will be given.
* OACC reserves the right to cancel class that does not meet the minimum enrollment.
* OACC has the right to cancel classes in case of emergencies that would compromise our student's safety.
Payment Policies:
* If you are taking a monthly class, payment is due on the first class date of each month.
* If you are late with class payment, a $10 late charge will be added.
* You will not be able to attend class if tuition is not paid.
* Please turn in all class payments to OACC front desk.
* All payments must be made by cash, credit card, or check.
* Please make check payable to Oakland Asian Cultural Center (OACC).
* All payment is final, no refunds.
Penalty Charge:
A $25.00 fee will be charged on returned check and "payment stopped" check.
(任何人在使用本文化中心之樓宇範圍內或表演時,無論如何均不得向本中心及教師們提出控訴或要求受傷賠償。本中心及教師絕無任何刑事及民事責任。
課程條例:
*所有課程都按先到先得註冊條例。
*如要參加本中心任何課程或講習班,均必須填寫簽署報名表。
*如果您錯過一堂課,您也許可以補課,但須經由課程老師決定,但都將不會退學費。
*本中心將保留取消未達到最低報名學生人數的課程的權利。
*本中心保留為維持學生安全,取消課程的權利。
付款條例:
*如果您上的是每月一次的課程,學費需在每月第一堂課時繳清。
*若您遲付學費,將繳交$10遲付款費。
*若學費未繳,將無法上課。
*請在本中心櫃台繳付學費。
*本中心接受現金、信用卡及支票付費方式。
*若使用支票,請開給:Oakland Asian Cultural Center。
*所有繳費均無退款。
罰款條例:
*若您的支票退票或停止付款,本中心將加收$25.00手續費用。
I have read and will comply with the above General Policies, Payment Policies and Penalty Charge. (我已閱讀並瞭解上述所有條款,並認同。)
*
Signature (簽名)
Date (簽名日期)
Emergency Contact (緊急聯絡人)
Emergency Contact Name (緊急聯絡人姓名)
*
Emergency Contact Relation to Student (緊急聯絡人與學生的關係)
*
Emergency Contact Phone Number (緊急聯絡人的聯絡電話號碼)
*
Powered by
EMF
Online Form Builder
Report Abuse