Instructor Change/Feedback/ Concern Report

Date 今天日期

First Name 名字

Last Name 姓名

Email 电邮

Phone/Mobile 电话/行动

Is this for yourself or your children? 这是给您自己还是您的孩子？

Myself 自己

My Children 我的孩子

How many of your children are affected by this particular instructor? 您有几位孩子目前正在和这一位老师上课或受到影响？

Child First Name

Child Last Name

Child First Name

Child Last Name

Child First Name

Child Last Name

Child First Name

Child Last Name

Child First Name

Child Last Name

Name of Instructor 老师姓名

What's your main concern? (Required) 您想反馈或告知办公室什么事情或情况？（麻烦填写）

Did you try to communicate any of your concerns with your teacher first? 您是否已经尝试先与老师沟通任何您的疑虑或想法？

Yes, I did 是的，我已经尝试了

No, I did not 我还没有

I do not feel comfortable 我觉得自行反应给老师有些不妥或不舒服

Any things you would like to share with our office? 任何您还想与我们的办公室分享的资讯？

Would you like us to keep your concerns or issues private without notifying your teacher? 您希望我们将您的疑虑或问题保密而不通知您的老师吗？

Yes, please keep it private without sharing, we just want to inform office 是的，请保密，不要分享，我们只是想通知办公室

No, but please keep our name private, we still need office to communicate with the teacher 不是的，我们需要办公室与老师沟通，但请把我们的名字保密，

No, we need office to communicate with the teacher and we do not mind that office share our name and brings our concerns directly to the teacher 不需要，我们需要办公室与老师沟通，并且我们也不介意办公室分享我们的名字和麻烦把我们的忧虑和担心直接转给老师

Others 其他

"Others" in more detail 上方“其他” 更详细解释

What would you like to do? (You can pick more than one) 您希望接下来如何处理？（您可以选择多项选择）

Switch/Change my teacher 更改我的上课老师

Only express my concerns 只是希望表达我的想法

Would like the office be aware of 只是希望办公室知道这些事情

Stay with the same teacher, but need office to communicate with the teacher 继续保留和目前老师上课，但是希望办公室可以出面和老师反应和沟通

Others 其他

Any other things you would like to share with us? 您还有其他任何想法想和我们分享吗？

We appreciate you spend the time to express your concerns and let office know how you truly feel!

我们忠心感谢您花您宝贵的时间表达您的想法或担忧，并和我们办公室分享您真实的感受，再一次感谢您，您的反馈，我们会非常重视！