Registration Form
The Bangor Chinese School of CLCC
53 Cumberland Street, Bangor, ME 04401

Last Name______________ First Name __________________Middle Initial__________

Chinese Name___________________ Email Address _____________________________

Social Security Number ______________Date of Birth _________Telephone__________

Home Address_______________________ City ___________State ________Zip_______

Industry ________________Title___________________ Cell Phone_________________

I am a Chinese beginner_____________________(or) Chinese intermediate____________

I would like to register:

                                         Chinese Language for Beginners__________

    Chinese Language for Intermediate________

                                         Chinese Culture Study__________________
                                 
                                         Teaching In China______________________

       Business Communications in Chinese_______

       Tourist Trainings and Information Guides____

Date  of Expected Enrollment _______________Re-entry Date______________________

Small Group__________________________(or) Individual Instruction________________

I knew the school from: Advertising _____Website ________Friends _______Others_____

Signature__________________________                                 Date_____________________

学习中文    了解中国
Learn Chinese and know China
Thank You! _ 谢谢!