题目内容：

阅读下面邮件，请你填写李强申请学校俱乐部的有关信息。

Dear Sir,

My name is Li Qiang. I’m in Class 3, Grade 2, and I’m thirteen and a half years old. I want to be in a club in our school. I do well in languages and I can speak English very fluently（流利地）. I can also play the piano very well. I took part in several English competitions. Last year in School English Show I got the first prize. So I think I can be in the English club. Can I join you? Me email is liqiang666@163.com. Please write me back and let me know.

Li Qiang

Application（申请）for School Club Student’s name :                   Li Qiang Grade and Class:                    1. Age:                                2. Club he wants to be in:             3. Result in School English Show:      4. E-mail address:                     5.