APPLICATION FORM
China Programs: Chinese Language, China Business and Martial Arts
Write clearly. Apply early. Application Deadlines: See CSC Calendar.
Late applications, contact Lina: Chinese-edo@hotmail.com

First Name
Last Name
Mr / Mrs / Miss / Ms / Dr / Professor

E-mail
Date of Birth_____________Age
Male / Female

City
State
Zip code

Country
Place of Birth
Phone (H) (            ) (             )
                  country    city		 Phone (w) (            ) (             )
                  country    city		 Fex (            ) (             )
           country    city

Nationality
Passport No
Native language

Occupation
Academic Institution / Employer

Program options (circle one):
Total Program (Tuition, Accommodation, Insurance, Activities etc) /Tuition Only/ Tuition Plus/ Accommodation Only with TO/TP

Program Title
Duration (weeks)
Program Code (if available

Program Start (e.g. Wed, Apr 10)
Program End (e.g. Wed, Jul 3)
For Martial Arts only. List preference of form/s or style/s:
Previous China Language or Martial Arts Studies
Dates (e.g. Jan, 2000 to Jan, 2001) Where (name of institution) Hours per week Level
       
       
Circle the most appropriate number of Chinese words you know: None (Total Beginner) / Approx. 800 / Approx. 1500 / Approx. 2500 / Approx. 3500

Are you receiving a credit transfer for this Program from your college or university?
Yes / No If yes, how many credits?

What other languages have you studied?

How did you hear about this China language program?

Have you participated in another Chinese Language Program?

Accommodation
Double Share / Individual
Extra accommodation ______________nights

Accommodation Start (day before start of program)
Accommodation End (day after the last day of program)

For shared accommodation: Do you smoke? Yes / No
Do you prefer to live in a smoke-free room? Yes / No
Remarks
(e.g. Joint Application – state name of joint applicant / Re-enrollment)
Person to contact in case of emergency

Name

Relationship (e.g. father)

E-mail
Phone (H) (            ) (             )
                  country    city		 Phone (w) (            ) (             )
                  country    city		 Fex (            ) (             )
          country    city
Address

Date Application Fee (US$ 100) was paid
(e.g. Feb 4)

 Paid by:
Bank transfer / Certified Bank Check / Money Order
Name of Bank

Program Fee		 Any Deductions
CSC Alumni / Joint Application / Other $
Any extras
Total Program Fee
(Bank charges must be paid by the applicant)
Enrollment Deadline

I agree that:
1) The above information is true and documents given in support of my Application are complete and correct.
2) I will abide by the laws of the People's Republic of China and will not engage in activities that bear no relation to my academic pursuit in China.

Signature of Applicant / Parent or Guardian if under 18 years old Date
Comprehensive information on CSC Education's China Program, Fees, Features and How To Apply guide is available at www. CSC.com.
For any questions, e-mail Chinese-edo@hotmail.com