小学申请表

发展全人教育 To develop our students’ full potential

传承中华文化 To give our students a foundation in Chinese language and culture 拓展国际视野 To help our students become global citizens

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Languages spoken by the applicant (Please rank in order of how much the applicant actually speaks these languages) :

申请人使用的主要语言(请按申请人实际使用不同语言的多少排序）：

How many years has the applicant been speaking speaking Chinese？ 申请人已学中文多少年？

English ？

申请人已学习英文多少年？

For Primary School admissions, all transfer students’ parents will be required for interview following the interview of their child. For Secondary School admissions, all parents will be required for interview. *所有小学转学申请人家长会在学生面谈后被要求面谈。中学申请人家长都需参加家长面谈。

Language Preference for Parental Interview 家长面谈语言：

□English 英文 □Chinese 中文

Educational Background of Applicant 申请人教育信息 Current School Address/Tel (if applicable): 现就读学校 地址/电话：

Main Teaching Language 主要教学语言：Grade/Year Completed 完成的最高学年：

Type of School □Chinese Curriculum (Please give details if it is a special section of a Chinese school, 学校类型： eg.: PYP, International 中国学校 (如是中国学校的特殊部门，例如：PYP 部，国际部等，

请具体注明： )

□ International Curriculum 国际学校

□Other 其他学校：

Previous School Address/Tel: 曾读学校地址/电话：

Main Teaching Language 主要教学语言：Grade/Year Completed 完成的最高学年：

Type of School □Chinese Curriculum (Please give details if it is a special section of a Chinese school, 学校类型： eg.: PYP, International Section: ) 中国学校 (如是中国学校的特殊部门，例如：PYP 部，国际部等，

请具体注明： )

□ International Curriculum 国际学校

□Other 其他学校：

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Does the applicant have any allergies or medical conditions of which we should be aware？ 申请人有食物过敏或其他健康状况需要学校特殊照顾吗？ □ Yes 是 □ No 否

If yes, please provide further details: 如果有，请给我们更多详情：

Does the applicant have any special educational needs or behavioural problems？ 申请人是否有其他特别教育需求或行为问题？ □ Yes 是 □ No 否

If yes, please explain: 如果是，请说明解释：

Note: the school may not be able to support children with certain special medical or educational needs. 注意：学校可能无法支持有特殊医疗或教育需求的学生。

Does the applicant have any special abilities or hobbies？ 申请人是否有某些特别技能或爱好?

Has the applicant ever represented his/her school or other organisation in sports, music, games, etc:？ 申请人是否代表学校或其他机构参加过体育，音乐，游戏等活动?

If you intend to send the applicant for university studies in the future, where do you hope they will undertake their studies？

如果您计划将来送申请人就读大学，您会选择哪里的大学？

□University in Mainland China 国内大学 □British University英国大学

□American University 美国大学 □University in Hong Kong 香港大学

□ Other University （please give details below） 其他大学 （请在以下空位详述） □ Not decided yet 未决定

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Parent Information申请人家庭信息 Name 姓名： Business Tel 办公室电话： Mobile 手机号码： Fax 传真： Email 电子邮件：

Native Language(s) 第一语言：

Second Language(s) 第二语言：

Occupation, Position and Company

公司，职业，职位：

Educational Level Attained 最高学历：

Applicant lives with: □ Father and Mother □ Father □ Mother □ Guardian

申请人与谁居住： 父母 父亲 母亲 父母以外的监护人

*If the applicant lives with a guardian, the parents are requested to sign a letter of authorization, and the personal details of the guardian should be given to us for filing.

如申请人与父母亲以外的监护人居住在一起，请父母亲给我们提供签字授权书和监护人详情。

Father/Guardian 父亲/监护人

Mother/Guardian

母亲/监护人

How many children are there in your family？ 家中共有几个孩子？

Sibling 1 兄弟姐妹1 Name 姓名： Date of birth 生日：

Current School 现就读学校：

Sibling 2 兄弟姐妹2 Name 姓名： Date of birth 生日：

Current School 现就读学校：

The place of applicant in your family (e.g. first-born, second-born etc).

申请人是家中的第几个孩子：

Sibling 3 兄弟姐妹3 Name 姓名： Date of birth 生日：

Current School 现就读学校：

Sibling 4 兄弟姐妹4 Name 姓名： Date of birth 生日：

Current School 现就读学校：

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Does the applicant have any brothers or sisters who are currently attending YK Pao School, or who you intend will apply to YK Pao School in future？ Please specify: 是否有兄弟或姐妹会申请或就读包玉刚实验学校？如果有，请注明：

How did you learn about YK Pao School？ 您是怎样知道包玉刚实验学校的？ □ From my friends 朋友 □ From school teachers学校老师

□ From web search (please give details of which search engine below)

网络搜索 (请在以下空位具体阐明)

□ From advertisement (please give details of which media below) 广告（请在以下空位具体阐明） □ From other channels (please give details) 其他渠道（请具体阐明）

□ Have you attended a YK Pao School introductory meeting？ 家长已经参加过学校的介绍会。 □ Have you visited the School? 家长已经参观过学校。

□ Have you checked the School through your own channels? 家长已经通过自己的渠道对学校进行过了解。

In your opinion, what are the major skills a student should learn in school？ 家长认为学生在学校中应该学到的最主要的能力是什么？

How do you think you can support our school and the applicant？ 家长认为可以给学校和申请人怎样的支持？

What is the main reason you chose YK Pao School？ 家长选择包玉刚实验学校的原因：

Is there any further information you wish to share with us？ 其他您想告诉我们的：

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Application Checklist: 申请材料

□ Completed and Signed Application Form with child’s recent photo 填写完成贴有照片并签字的入学申请表

□ Copy of first page and applicant’s page of the Household Register (for Chinese mainland citizens) / passport and valid visa (for Non-Chinese mainland citizens)

户口本首页和申请人本人（学生）页复印件(中国大陆学生) / 护照及有效签证复印件（非中国大陆学生） □ School reports from the past two years 最近两年内的学校报告

□ Secondary School applicants: Recommendation letters from current teachers (optional). Please use the format we provide for recommendation letters.

中学申请人提供现就读学校推荐信 (可选) ，推荐信格式请使用我校提供的版本 □ Recent photograph of the applicant with parents 申请人近期与父母亲合影照片

□Any other reference materials requested by the School. 其他学校可能会要求的参考资料。

Parental Agreement 家长协议

In signing this application, I give YK Pao School permission to contact the applicant’s previous schools should additional information be required for the purpose of this application. I agree to abide by the admissions procedures of YK Pao School.

I certify that the information given on this form is full and complete to the best of my knowledge and understand that, if I fail to provide accurate details of important information about the applicant, YK Pao School reserves the right to restrict entry into or withdraw the applicant’s place from the School. 我签署该申请表，我准许包玉刚实验学校为此申请从申请人以前就读的学校获取相关信息。我同意遵守包玉刚实验学校的入学程序。

本人确认该申请表中信息完整准确。如本人未准确提供申请人的重要信息，包玉刚实验学校有权限制入学或退学。

Signature of parent/guardian Date 父母/监护人签名 日期

Please send application form to：

Lane20, 1251 West Wuding Road, Shanghai Postcode: 200042 Tel: (+86) 21 6167 1999 Fax: (+86) 21 6073 0556

Website: http://www.ykpaoschool.cn

请邮寄申请表至以下地址： 上海市武定西路1251弄20号 邮编：200042

电话：(+86) 21 6167 1999 传真：(+86) 21 6073 0556

电子邮件：网址：http://www.ykpaoschool.cn

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