Birthday

Nationality

Email

Phone Number

Current School

Major

Study Type

Advanced Study (     )  Language Study (    )  Diploma Study(    )

Education Background  *Please start with middle school, end with current school.*

Level

School Name

Time (year and month)

Middle School

Sample School

2015 Sep. - 2018 Jul.

I certify that all of the above information are truthful. Student Signature:

Reference Name

Title

School Name

Reference Notes:

Signature:                

Birth Country

Birth Place (Province/State)

First Language

Religion

Priority Status

None (    )  Children of Diplomats (    )  Children of Dignitary (    )  

Dignitary (    )  Children of Friends of the Chinese People (    )  Other (    )

Special Student

None (   )  Active-duty Soldier (   )  Journalist (   )  Religion Figure (   )  Citizen of Non-diplomatic Country (   )  Personnel of Foreign Consular Office (   )  Partner of Personnel of Foreign Consular Offices (   )  Other (   )

Occupation

Employer/School

Current Address

(include country)

Source of Funds

Sponsor

Scholarship