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 table 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 (optional)

Emergency Contact

* Contact Name

* Contact Number

WeChat Account (optional)

Any physical and mental health concerns? Any notes to us? (optional)

Mandarin Level Self-Assessment

* Listening




* Speaking

* Pinyin

* Writing

* Approx Number of Mandarin Words Already Known:

*Required Info

© 2020 by MapleShine Education Inc.  

102-5575 North Service Road, Burlington, ON  Canada


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