BeiDouXing Member Contact Info

BeiDouXing Member Contact Info and Newsletter Subscription

Please fill out this form to update your contact info for inclusion in the BeiDouXing membership directory and/or to receive periodic parent updates..
Do you have a child that will be in the XinXing program during the 2018-2019 School Year? *
NOTE: THIS FORM HAS CHANGED! The information entered here will REPLACE all existing contact info on file with Bei Dou Xing. Please fill out all relevant fields, even where there is no change.
Student Name (oldest child in XinXing)

First Name Last Name
Grade Level (oldest child in XinXing during 2018-2019 school year)
Select Grade for Student #1 (oldest child)
Student #2 Name

First Name Last Name
Grade Level Student #2 (2018-2019 school year)
Select Grade for Student #2
Student #3 Name

First Name Last Name
Grade Level Student #3 (2018-2019 school year)
Select Grade for Student #3
Parent/Guardian #1 Name

First Name Last Name

Family Phone Number

- Area Code Phone Number
Parent #1 Phone

- Area Code Phone Number
Parent #2 Phone

- Area Code Phone Number
Family E-mail
Enter the primary family e-mail address
Parent #1 E-mail
Enter a second e-mail for Parent #1, if applicable
Parent #2 E-mail
Enter a second e-mail for Parent #2, if applicable
Additional Info
Use this area to provide instructions or additional info not captured above
Full Name

First Name Last Name
Enter Email address to receive future BDX updates
Should be Empty:

BeiDouXing Member Contact Info and Newsletter Subscription