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

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

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

First Name Last Name
Parent #1 Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Parent/Guardian #2 Name

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

Enter Second Address
Parent #2 Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
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

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.