Silicon Valley Chinese School Enrollment Form

New Student Application Form

Note: If you are a returning student and wish to apply for a placement test so you can skip to a higher grade, please do not complete this form. Please click the URL, below:

Returning Student Skip Grade Application

* Required

* Registering for which School Year?

* Has the child previously attended SVCS?

* Last grade student attended at SVCS:

* Last school year student attended SVCS:

* Please specify:

* Siblings currently attending SVCS?

* (Oldest) Sibling's First Name:

* (Oldest) Sibling's Last Name:

* (Oldest) Sibling's Class #:

(Oldest) Sibling's Student ID:

A. Student Information

* First Name:

* Last Name:

Chinese Name:

* Date of Birth:

Date format is YYYY-MM-DD

* Gender:

Student's Phone:

Format should be in xxx-xxx-xxxx Multiple number separated by space

Student's Email:

Please enter valid email addresses, separated by comma

Confirm Student's Email:

* Day-time School for 2017-2018 school year:

* Grade in day-school for 2017-2018 school year:

* Grade planned on entering SVCS: (If you choose CSL Level 2 or 1st Grade and up, the student is required to attend a placement test.)

* With the exception of applying to CSL Level 1, Pre-School, and Kindergarten classes, new students applying to any other grade must attend a placement test before completing registration. The placement test dates are listed below. Please select one. (Important: Placement Test for AP class will only be held on August)

June 3, 2018; CSL and Mandarin Grade 1 -- 12; 9:00 AM @ Calabazas Branch Library (1230 South Blaney Ave. San Jose, Ca 95129)

August 2018; Date, Time, and Location are TBD

B. Parent/Guardian Information

* Parent/Guardian #1 English Name:

Parent/Guardian #1 Chinese Name:

* Parent/Guardian #1 Phone:

Format should be in xxx-xxx-xxxx Multiple number separated by space

Set as contact number?

* Parent/Guardian #1 Email:

* Confirm Parent/Guardian #1 Email:

Parent/Guardian #2 English Name:

Parent/Guardian #2 Chinese Name:

Parent/Guardian #2 Phone:

Format should be in xxx-xxx-xxxx Multiple number separated by space

Set as contact number?

Parent/Guardian #2 Email:

Confirm Parent/Guardian #2 Email:

* Street Address:

* City:

* State:

* Zip Code:

* Preferred contact Number:

* How did you hear about SVCS?

Please Specify:

* Is the referrer a parent/guardian of a current SVCS student?

* What is the referrer's name?

* What is that current SVCS student's first name?

* What is that current SVCS student's last name?

* What is that current SVCS student's class?

C. Emergency Contact (Emergency contact can not be the parent or guardian listed above.)

* Name of designated emergency contact (in English):

* Telephone number of designated emergency contact:

Format should be in xxx-xxx-xxxx Multiple number separated by space

* Relationship to student:

Please Specify:

* Name of Student's Doctor:

* Phone number of the doctor:

Format should be in xxx-xxx-xxxx Multiple number separated by space

Insurance Company:

Insurance Policy/Group Number:

Insurance Identification Number:

D. Parent/Guardian's Consent

(1) I give my permission for my child to participate in the SVCS program and authorize the school personnel to take full charge of any emergency. I will not hold the SVCS, Lynbrook High School, or any school member liable in case of accidents or injuries.

(2) I have checked and corrected all information in this form. I am responsible to inform the school for any changes.

(3) I have read the "Registration Information". I understand that if I do not follow the registration process correctly, SVCS reserves the right to cancel student enrollment in this program.

(4) I have read the "Student Parent Handbook". I understand that if my child or I do not follow the school policies specified in the handbook, SVCS reserves the right to terminate student enrollment in this program. I also understand that the SVCS will not refund tuition nor registration fee.

(5) I understand: AP Chinese Exam is hosted by the College Board and it is my responsibility to register for the exam; current SVCS students who are attending high school have priority over new students and Juniors and Seniors have priority over Freshmen and Sophomores; completing AP class is irrelevant to graduation.

(6) I hereby grant and assign the SVCS the irrevocable and unrestricted right to use and publish photographic, video and digital/non-digital images of my child.

* I have read the above consent infomation, and agree.

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