Summer Language and Culture Exchange Program 2012
Application Form
n Thank you for applying for the Summer Language and Culture Exchange Program 2012.
n It is very important to fill out the application form below correctly as all the summer school information and acceptance letters will be sent out according to the information you provided below.
● Personal Information
* Full Name / (As shown in Passport)*Family Name / Surname / (Please indicate dash (-) if not applicable)
* Gender / ○ male ○ female
* Date of Birth / / / (DD/MM/YYYY)
* Citizenship Country
* Passport Number
● Home University
* Home University* Current Major
* International Coordinator
* Advisor / • Name
• Title
• Phone
● Contact Information
* Home Address* Home Number
ex) +82 32 860 7031
(Please include the country code and area code)
* Mobile Number
ex) +82 10 8880 7031
(Please include the country code and area code)
● Course Selection
* Program Module / ○ A ○ BA ○ BB● Person to contact in the event of emergency
* Name* Relationship
* Address
* Phone
● Survey for the program
*Have you ever visited China before?* What do you expect most in this program
● Declaration
Please verify that the details and choices of your application are correctly entered before proceeding to submit.
1、I declare that all the information I have given in this application is true and correct.2、I have obtained approval from my home university to participate in Summer Language and Culture Exchange Program 2012.
3、I fully understand that if I am successful in my application, I am responsible for paying my own personal expenses such as meals, insurance, accommodation, transport, etc.
4、I recognize that by taking part in Summer Language and Culture Exchange Program, I commit myself to behave according to both host and home universities' rules and regulations.
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