Register Here! Please fill out the form below .
Student Information

First Name:     

Last Name:    

Date of Birth:  (Example: 01/12/1986)

Gender:        

School:               Grade:    

Physician:       

Phone:             (Example: 713-888-8888)

Medication:   

Allergies:       
 
Parent/Guardians Information

Father's Name:

Mother's Name:

Street Address:

City:      State:      ZIP:      

Home Phone:                       (Example: 713-888-8888)

Fax:                               

Father's Daytime Phone:      

Father's Cellular Phone:  

Mother's Daytime Phone:

Mother's Cellular Phone: 

Emergency Contact :      (Not Parent)

Phone:                           
 

Class Information
After School Tutoring:

After School Tutoring (Mon-Friday):

Class Language:
Traditional Chinese Simplified Chinese English
Academic Subject Tutoring:

Math   Computer   SAT/PSAT   Spanish

Chinese   English   G.T   Biology  

Physics   Chemistry
Summer Camps 2004:

Domestic Summer Camp

Domestic Summer Camp for International Students
Transportation Services

Days of Pick-Up

MonTueWedThurFriSat

Time of Pick-Up:

How did you hear about Fame Well Education Center?

I, the undersigned, as the legal guardian of the student above hereby granting authority to the staff of Fame Well School to render a judgment concerning medical assistance in the event of an emergency/accident in my absence. I agree not to hold FWEC or its employees responsible in any way while any accident occurs during transporting my child.
Yes I agree statement above


 
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All rights reserved