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Application Form - A-level center (15-18 years old)

(As per Their Passport 以护照为准)

Please put NA if not applicable.

Subject to age restrictions, the relevant department will contact you for supporting Scholarship documents. 根据年龄的限制,本校相关部门会就奖学金事宜与您联络。

Language | 语言信息

Other Languages Spoken | 其他语言

Activities and Interests | 活动和兴趣

Parents information from both sides are highly suggested.

Parent Information

Other Languages Spoken | 其他语言

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If you are unsure about creating a personal account but would like more information about Wellington College International Tianjin, please contact our admissions team on + 86 022 – 87587199, or email to

Work Address | 工作所在地地址

China Address | 中国现居住地地址

Home Country Address | 本国家庭住址

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Siblings Information

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Academic History | 就学经历

(Most Recent First 从最近求学的学校开始)

Previous Schools

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Asperger’s Syndrome | 阿斯伯格综合征
Attention Deficit Hyperactivity Disorder | 注意力不足过动症
Autism | 孤独症
Dyslexia | 阅读障碍症
Dyspraxia | 运用障碍
Depression | 抑郁症
Eating Disorder | 厌食症
Emotional/Behavioural Delay/Disorders | 情绪/行为发育迟缓症
Language and Speech Delay/Disorders | 语言发育迟缓症
Learning Disabilities | 学习障碍
Any other condition which we should be aware of | 其他您认为校方应该了解的孩子情况

Medical Information | 医疗信息

Please select Yes if your child has (or has had in the past) any of the following conditions and provide additional information on such condition (or any other condition if not listed).
如果您的孩子具有(或者曾经有)下述状况,请在表格内标示 “Yes”,并向校方提供孩子的详细情况说明 (如您的孩子的情况并未出现在下列表格中,请务必向学校说明。)

Health Information
Immunization Record

Has your child received the following vaccinations? 您的孩子是否曾接种过下列疫苗?

Measles Mumps Rubella (MMR) | 麻疹腮腺炎风疹

Date of Vaccination | 接种疫苗日期

Diphtheria Pertussis Tetanus (DPT) | 百日咳白喉破伤风

Date of Vaccination | 接种疫苗日期

Hepatitis B (HepB) | B型肝炎

Date of Vaccination | 接种疫苗日期

Hepatitis A (HepA) | A型肝炎

Date of Vaccination | 接种疫苗日期

Tuberculosis (B.C.G.) | 肺结核

Date of Vaccination | 接种疫苗日期

Haemophilus Influenzae Type B (Hib) | B型流感嗜血杆菌

Date of Vaccination | 接种疫苗日期

Chicken Pox | 水痘

Date of Vaccination | 接种疫苗日期

Rabies | 狂犬病

Date of Vaccination | 接种疫苗日期

Annual Flu Vaccine | 年度流感疫苗

Date of Vaccination | 接种疫苗日期

If your child has medical insurance, please provide details. 如果您的孩子已经办理了医疗保险,请提供相关信息。

Note: Medical and Liability: The Parents are responsible for the medical insurance/insurance of Pupils while attending the College and must make provision before attending the College. Unless negligent or guilty of some wrongdoing causing injury, loss or damage, the College does not accept responsibility for accidental injury or other loss caused to the Pupil or the Parents/Guardian or for the loss or damage to property.


Person(s) to Notify in an Emergency

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Emergency Medical Treatment: It is the Parents/Guardians responsibility to make adequate provision for medical insurance during the pupil’s enrolment at the College.


Payment Details | 付款信息

School Fees | 学费

Lunch Fees | 午餐费

Bus Fees | 校车费

If Company payment for the above, please provide the following details.
如果上述费用由公司支付,请提供下列信息 。

In consideration of submitting this application, I/we being the Parent(s)/Guardian of the pupil jointly agree with the following:

1. I/we will abide by Wellington College International Tianjin policies and procedures as notified to us from time to time

2. That Wellington College International Tianjin has our permission to contact my/our child’s previous school in order to obtain information relevant to this application.

3. That we have read and understood the policies regarding school fees and that I/we agree to pay all fees and tuition according to Wellington College International Tianjin policy.

4. I/we will promptly inform the College if any given information described in this application form changes.

5. That all holders of parental responsibility for the below-named pupil have signed this Application Form and that no one else holds parental responsibility for him/ her.

6. I/we confirm that I/we reside in China/Tianjin and that our child will reside with at least one parent (unless boarding). Our child has/will have legal China/Tianjin residency status and we have provided copies of our resident permits and China/ Tianjin work permits, including the pupil’s resident permit with this application, or if not yet available, no later than one month from the enrolment date. Should we be unable to provide proof of legal residency, Wellington College International Tianjin reserves the right to ask my child to leave the College and all tuition fees paid will be forfeited.
我/我们确认我/我们在中国/天津居住,且我们的孩子中国/天津居住期间有至少父母中的一人陪护(参加本校 寄宿项目除外)。我们的孩子具有/将获得合法的中国/天津拘留身份,我们已提供我们的居留许可证和中国/天 津工作许可证的复印件,包括学生的居留许可证,与此申请一同提交至校方,如资料不齐全,将在孩子入学后 的一个月之内将资料补齐。如未能提供合法的拘留许可的文件,天津惠灵顿国际学校有权要求该学生退学,并不再返回任何该学生缴纳的费用。

7. I/we certify that I/we have fully and accurately disclosed in this form all medical, behavioural, emotional and other issues that might affect our child’s life at Wellington College International Tianjin. I/we agree that the College shall have the right to assess at any time whether it can provide or continue to provide adequate educational care and provision to our child. I/We understand that failure to have complied with accurate and complete disclosure is grounds for nullification of a pupil’s enrolment at Wellington College International Tianjin.
我/我们承诺已经向天津惠灵顿国际学校提供了孩子的所有的医疗、行为、精神等可能对其在校就读产生影响的 情况说明。我/我们同意校方有权在任何时候查阅与孩子相关的适合的教育关怀的信息。我/如因我/我们未能准 确并完整地提供孩子的信息,天津惠灵顿国际学校有权取消孩子的入学资格。

Date: May 31, 2020
Date: May 31, 2020
Final Checklist