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 2020-2021 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 NameLast Name
Grade Level (oldest child in XinXing during 2020-2021 school year)
Select Grade for Student #1 (oldest child)
Student #2 Name

First NameLast Name
Grade Level Student #2 (2020-2021 school year)
Select Grade for Student #2
Student #3 Name

First NameLast Name
Grade Level Student #3 (2020-2021 school year)
Select Grade for Student #3
Parent/Guardian #1 Name

First NameLast Name
Parent #1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian #2 Name

First NameLast Name
Check here to enter a Different Address for Parent #2

Enter Second Address
Parent #2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Family Phone Number

Area CodePhone Number
Parent #1 Phone

Area CodePhone Number
Parent #2 Phone

Area CodePhone 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 NameLast Name
Enter Email address to receive future BDX updates
Should be Empty:

BeiDouXing Member Contact Info and Newsletter Subscription

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.