Registrant Details |
|
First name:* |
|
Middle Name: |
|
Last name:* |
|
Address: |
Street Number and Name |
|
City: |
|
State: |
|
ZIP: |
|
Gender: |
Male
Female
|
Age: |
|
Day/Night Phone:* |
|
Email:* |
|
Have you studied Chinese before?: |
|
If yes, please answer the following, How long? |
|
Where/at what school?: |
|
|
Please indicate the course you want to take (include course code) from the course listings: |
Course Number: |
|
Course Title: |
|
Course Fee: |
|
How did you hear about us? |
|
|
|
|