Name
*
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
(###)
###
####
Date of Birth
MM
DD
YYYY
Height (ft. in.)
Weight (lbs.)
Gender
Language
School
Grade
Work/Program
Name
First Name
Last Name
Chinese Name
Cell Phone Number
(###)
###
####
Email
Language
Is father a Christian?
If yes, what affiliation?
Name
First Name
Last Name
Chinese Name
Cell Phone Number
(###)
###
####
Email
Language
Is mother a Christian?
If yes, what affiliation?
What name does your child prefer to be called?
Language normally used
Specify any developmental or learning disability
Which topic or things does your child find most interesting (e.g. superman, car?)
What areas are your child most scared of (e.g. darkness, water)?
What areas are your child most gifted in (e.g. music, memory, sport, drawing)?
Is your child under medication? If yes, what type of medication?
What are the things that we have to pay attention to (e.g. allergic to certain food, special verbal, physical behavior or distress signal)?
Simple description of the child's daily routine (e.g. work or after school activities, present treatment or therapy).
Under special circumstance during Sunday school time, who do you want us to contact first?
Please list order of priority. Father, Mother, Other (name and phone number)
Any other things you would like us to know?
Affiliation
