2017 Application Form for 2 week school

申請表(Application Form)
International Student Application Form (p.1/3)

Chinese Seasonal Course
Chinese Language Center 華語文中心

Instructions

● Please complete this form in BLOCK LETTERS
in English
● Read and SIGN the conditions of enrolment
● Mark relevant boxes with an X
PASSPORT
● My application is through a representative: □No
PHOTO
□Yes
● Please fill out the form and send it with the rest
of the application materials to the below
address or by e‐mail
● Return to: No.1 Syuecheng Rd.,Sec. 1, Dashu Dist., Kaosiung
City 84001,Taiwan R.O.C. Chinese Language Center

E-mail: shingjui@isu.edu.tw
Family Name:

Given Name:

Chinese Name:

Gender
□Male

Date of Birth

Nationality

□Female

Emergency contacts:
Relationship:
Name:
Mobile:

/(D)

/(M)

/(Y)

Mobile:

Passport Number:

E-mail:
Address for correspondence :

Do you take any medication or have a medical condition? □Yes □No
If yes, please details ___________________________________________________________
Education Background Highest Education：□Senior High School □University
□Master Degree
□Ph.D Degree
School Name: _____________________________

Major: __________________________
Graduated : □Yes □No
Language Background (1) Have you ever studied Mandarin before?
□ Yes
□ No
(2) Where did you learn Mandarin?
□ Taiwan □ Mainland China
□ In your own country □ Other ( _________________ )

International Student Application Form (p.2)

Language Background (3) Please mark your Mandarin level
□ Basic (less than 1 year)
□ Intermediate (about 1-2 years )
□ Advanced (more than 3 years )
(4) Which have you studied?
□ Zhuyin
□ Pinyin
□ Simplified Characters
□ Traditional Characters

Checklist of required documents
 Application form (including study plan).
 1 passport photo
 Photocopy of diploma or photocopy of official school transcripts
.
 Photocopy of passport first page (must clearly show passport number, name, personal data and
photograph).
 Recent financial statement within 3 months proving the applicant has at least US$2,000.
Dormitory required
 Yes, please arrange a 4-person shared room for me. (9,300 NTD per term)
 Yes, please arrange a single room for me.( (42,000 NTD per term)
 No, I don’t need accommodation.
The information contained in this form will be basis of university record, please fill it in clearly and
correctly. I-Shou University reserves the right to computerize and utilize your personal information
for administrative purposes.
Applicant’s signature: ____________________________
Date: ______________________
Chinese Language Center of I-Shou