全 美 中 文 學 校 聯 合 總 會
National Council of Associations of Chinese
Language Schools (NCACLS)
4640
Timberlane Dr., Macon, GA 31210-3120
HAI-HWA SCHOLARSHIP PROGRAM
ESSAY CONTEST ON CHINESE HISTORY AND CULTURE
Dear Student: Please type or print the information requested below
and obtain the signatures of the Principal of your Chinese Language
School and your parent or guardian.
Name
:___________________________________________________________________________________________________
Last
First
Middle
(Chinese)
Home Address :
____________________________________________________________________________________________
Street
____________________________________________________________________________________________
City
State
Zip
Telephone:
( _________ ) —
__________________________ E-mail:＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿
Grade (Public School): ______________________
Age: _______
Sex: ______
Chinese Language School Attended（中、英文）:
________________________________________________
Principal Name（中、英文）and
Address: ______________________________________________________________
______________________________________________________________
______________________________________________________________
City
State
Zip
Telephone
: ( _________ ) — ______________________
Email: __________________________
School Enrollment Verification: Please have the Principal of your
Chinese Language School verify your current status of the school enrollment.
Signature of Principal: _____________________________________________
Date :_______________________
Signature of Parent or Guardian: _____________________________________
Date :_______________________
Please
mail this form with your essay by March 1, 2001 to:
Dr. N. C. Yang
4640 Timberlane Dr.
Macon, GA 31210-3120