(Nominated Student by NCCU Partner Universities Only)
Applicant
Full Name (in Chinese) / Full Name (in English)
Surname/Family Name / Given Name(in full)
Nationality* / Sex
□Male □Female / PassportNumber
Dateof Birth (mm/dd/yyyy)
/ / / Postal Code:
Mailing Address:
Telephone Number / Cell PhoneNumber / E-mail Address
*Citizens of People’s Republic of China (PRC) will be informed and required to fill out the relevant documents for the entrance to Taiwan after the submission of the application form.
Education Status
Name of the universityin which you are currently enrolled: ______
Currently-enrolleddegreeprogram: □Undergraduate □Master □Doctorate
Major:______
Do you need special care during your stay at NCCU?
□No.
□Yes. Please specify: ______
Dietary Needs
□No Restriction□Vegetarian□Other ______
Transcript Address
Receiver’s Name: / Phone Number: / Postal Code:
Mailing Address:
Emergency Contact Person
Full Name / Relationship / Telephone Number / Cell PhoneNumber
E-mail Address / Postal CodeMailing Address
Insurance Notice!
Please make sure to purchase and obtain the medical and accident insurance before your arrival in Taiwan. The insurance should cover all medical and hospital expenses for sickness or accident. In Taiwan, the medical or hospital expenses are expected to be paid at the time of treatment.
Chinese Comprehension Status
□Zero: have never learned Mandarin Chinese before
□Beginning: have learned 700-900 vocabulary words/ have received 180-360 teaching hours in Taiwan or China/ have received 360-720 teaching hours in other countries
□Low-Intermediate: have learned 1400-1800 vocabulary words/ have received 360-900 teaching hours in Taiwan orChina/ have received 720-1800 teaching hours in other countries
□Intermediate: have learned 2500-3000 vocabulary words/ have received 900-1440 teaching hours in Taiwan orChina/ have received 1800-2880 teaching hours in other countries
If you have learned Mandarin Chinese before, please answer the following questions:
1. Where did you learn Mandarin Chinese? □Taiwan □China □In your home country
□Other______
2. The period of learning Mandarin Chinese: from ______/______(mm/yyyy) to ______/______(mm/yyyy)
3. Language used in class: □Mandarin Chinese □Native Language □Both
Registration Fee
USD 150 (non-refundable)
CourseSelection
Chinese Language Program(Tuition Waived)
Course Title / Class Time / Class Day / Class Date
□ / 4-week Chinese Language Study / 1:10 p.m. – 4 p.m. / Mon. –Fri. / Jul. 04 – July 29
□ / 4-week Chinese Language Study / Aug. 01 – Aug. 26
□ / 8-week Chinese Language Study / Jul. 04 – Aug. 26
EnglishInstructedCourses (Tuition Waived)
□ / The Past and Present of Taiwan / 9 a.m. – 12 p.m. / Mon. – Wed. / Jul. 04– Jul. 13
□ / Chinese Classics: I-Ching, Confucianism, and Daoism
□ / Knowledge-based Economy and Multiculturalism
□ / Taiwan Cinema / 2 p.m. – 5 p.m. / Jul. 04– Jul. 13
□ / Modernization and the Development of Taiwan Indigenous Societies
□ / Principles of Management: Asian Perspective
□ / A Modern History of China, Taiwan, and Their Relationship with East Asia / 9 a.m. – 12 p.m. / Jul. 18– Jul. 27
□ / Societies and Politics of East Asia
□ / Cross-Strait Enterprise Development / 2 p.m. – 5 p.m. / Jul. 18– Jul. 27
□ / Culture, History, and Politics of Art in Taiwan
*Course Selection Minimum: one Chinese Study session or 2 English-taught courses
*When selecting the courses above, please make sure that you do not have any timetable conflicts.
*Please attend the Orientation: 10 a.m. / Sunday, July 3, 2016 /Conference Room No.1, 7F of Admin. Bldg.
Accommodation
□I will take care of my accommodation in Taiwan.
□I need information about the application and fee for the summer accommodation.The available rooms will be assigned on a first-come, first-serve basis. There is no guaranteed offer for accommodation.
Admission Letter(electronicdocument)
□I need an admission letter. □I don’t need an admission letter.
※Once you have filled out the form, please send it by e-mail ()before the deadline,April29th, 2016.
※Based on limited campus facilities and academic support resources, we reserve the right to admit or decline students.
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