Participant Information

Tell us some information about the participant to help us to serve you better! Please rate the participant’s Mandarin levels in the form below with “Excellent”, “Good” and “Poor”.

Basic Information

* Participant Full Name

* Phone Number

* Email Address

* Age (on the date of the program starts)

Home Address

* Address Line 1

* City


* Province


School Name

Current School Name

Emergency Contact

* Name

* Contact Number

Any physical and mental health concerns? Any notes to us?

Mandarin Level Self-Assessment

* Listening




* Speaking

* Pinyin

* Writing

* Approx Number of Mandarin Words Already Known:

*Required Info

© 2021 by MapleShine Education

Tel: 1-905-331-8868

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