【精品】武汉实验外国语学校小学部一年级新生入学报名表81.doc

武汉实验外国语学校小学部一年级新生入学报名表请下载后用白色a4纸正反两面打印，并如实填写（手写、打印均可）学生基本情况姓名性别身体状况身高近期1寸彩色登记照体重出生年月视力右左家庭情况称谓姓名年龄学历工作单位职务联系电话父母与孩子长期同住的家庭成员（在相应的选项下打“”）父母爷爷奶奶外公外婆哥姐妹弟 交往情况最好的两位朋友朋友的性格和好朋友最喜欢玩的游戏成长简历时间幼儿园（或地点）健康状况生活能力教师评价0岁至今家人对孩子的评价优点不足兴趣特长是否愿意走读（本部）是是否报考武汉外国语学校美加分校（全寄宿）是否否需要说明事项武汉实验外国语学校小学部一年级新生报名健康卡武汉实验外国语学校小学部是一所全日制寄宿学校，由于寄宿制学校管理的特殊性，请您报名前务必阅读以下条款并在同意后签字。1、请学生家长在“健康档案”中如实填写学生过往手术史、住院史及过敏药物。2、学生患下列疾病不宜报名：心脏病、梦游症、哮喘、蛋白质过敏及各类传染性疾病等。3、家长不实填写造成的后果由家长自行承担。健康小卡片学生姓名请逐项填写有无下列疾病心脏病有无哮喘有无蛋白质过敏有无梦游症有无癫痫有无药物过敏有无慢性疾病手术史其它疾病 监护人签字： 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