Student

Class

Campus
Katy Branch

Room
111

Tuition
Time
150
Sun 2:30PM-4:30PM

23132 san nicholas pl

Zip

77494

City

katy

State

tx

E-mail Address

linhuawang@hotmail.c
om
Home
Tel.

Mother's Name

Linhua wang

Tel.#

281217466 Late Fee

1
Parent Duty Fee

Father's Name

hongjie xiong

Tel.#

713382196
Total
8

Emergency
Contact

linhua wang

Tel.#

281693607
8
Check

Home Address

281 217
4661

RegisterID
28628

TuitionNo.
28628-1541

150.00

Registration Fee

10.00

0.00
10.00
170.00

Cash

Parent Duty

Yes

No Room Parent

Yes

100 80
No 50
20

I, the undersigned, hereby understand and agree that I will not hold HuaXia Chinese School, its officials, teachers
and volunteers liable for any bodily injury and property damage I and my child/children may sustain by associating
with and/or taking part in any of the activities sponsored by HuaXia Chinese School.The school does not discriminate
in any way with respect to student admissions on the basis of race, sex, color, religion, national origin, physical
disability and military status. Any one who is interested in learning Chinese language, culture and art and pays the
tuition, can enroll in the school, use the facilities and exercise student privileges.
/
Parent's/Guardian's Signature _______________________

Date______________________________________