Registration Form

Champion Learning Academy
Step 2. Submit Registration Form

To successfully register:
#1. Fill in and submit the registration form below
#2. Wait for contact from Champion within 1-7 school days.

If you receive Champion invoices, your registration has been processed.
If you are rejected due to full spot, we will put you in the waitlist for next enroll season.

#3. Pay the invoice online. (e-bank transfer)

Question? Email via [email protected] or call 919.388.1739.

2023-2024 Champion Learning Academy Registration Form

Upon submission of this registration form, you are agree to enrolled in 2023-2024 Champion After School Program (Annual Contract).

Please read the Champion After School policy carefully.

*Please fill out this form for your children one at a time.
*Submission of this form doesn't guarantee successful enrollment. We will notify you any updates: confirmation/cancellation.

* Indicates required field

Student *

First

Last

Date of Birth (YYYY/MM/DD) *

Gender *

Male Female

Chinese Name (optional) *

I am a *

New Student (please send your child picture to [email protected]) Returning Student

* New Student - Did Not Attend 2020-2021 Champion After School
* Returning Student - Attended 2020-2021 Champion After School

Mandarin Placement For New Student (*Required) Please let us know more about your child. (previous Chinese learning experience i.e. learning materials and period of learning, primary language used at home, language goals, etc,.) *

Sibling Discount: Sibling(s) who also register with this student in 2023-2024 school year. (First Name, Last Name *list all names) *

*Each sibling needs to submit his/her registration form.
2 Sibling Families
(*Registered Siblings in the same school year)
-the 1st sibling - original tuition rate
-the 2nd sibling with lower tuition rate with a 3% OFF Discount
3 Sibling Families
(*Registered Siblings in the same school year)
-the 1st sibling - original tuition rate
-the 2nd sibling with lower tuition rate with a 5% OFF Discount
-the 3rd sibling with the lowest tuition with a 5% OFF Discount

Fall 2023 School Name *

Grade in Fall 2023 *

School Calendar *

*Champion Learning Academy will meet on your school calendar's school days(No Class on all Teacher Workdays, Holidays, or Vacations).

Mandarin Class *

B class - Annual B class fee will be added on the tuition
AB class - If a same level A or B class are under minimum enrollment, A B students will be merged to one class with A class structure.
CSL,PK classes - If a minimum enrollment does not meet, CSL or PK class will be canceled.
*3B,6B Unavailable to choose.
*4A is currently full.

Tuition does not include any book fees. *

Comment *

Mother *

First

Last

Mother Email *

Mother's Phone Number *

Employment *

Emergency contact *

First

Last

Emergency Phone Number *

Father *

First

Last

Father Email *

Father Phone Number *

Employment *

Emergency contact *

First

Last

Emergency Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Payment Method *

How many days per week attend Champion? *

Five Four Three

Which Days? *

Start Date (MM/DD/YYYY) *

Medical Information (ex. Mask Exemption Reason) *

Policy *

I have read Champion Learning Academy Tuition & Schedule Policy carefully and I accept all terms and conditions listed on it. I acknowledge that families who apply Champion Learning Academy must commit to the whole school year. I acknowledge that Champion Learning Academy will only meet on your school days. No Class on all Teacher Workdays, Holidays, Track Out, or Vacations). I acknowledge that a $100 deposit fee charged, and it can be applied on the last year tuition of the Champion After School. You won't be charged again, if you have paid it before and it remains unused. I acknowledge that a $100 termination fee will be charged if early withdrawal from Champion After School Program. I agree that my child can be assigned to a same level class, if a class minimum does not meet. I acknowledge all classes are subject to low enrollment cancellation. I acknowledge that Champion will pick up students on scheduled early release days.

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Champion Learning AcademyStep 2. Submit Registration Form

2023-2024 Champion Learning Academy Registration Form

Champion Learning Academy
Step 2. Submit Registration Form