Ministry of Education Taiwan Scholarship

Application Form for

Ministry of Education Taiwan Scholarship

Please complete all pages of this form and submit IT WITH ANY ADDITIONAL INFORMATION IF APPLICABLE to the EDUCATION division of teco in canada

DURATION OF SCHOLARSHIP / A passport-style (35´45mm) photograph taken within the last 6 months
q Undergraduate Scholarship (4 years) q Master Scholarship (2 years)
q Doctoral Scholarship (4 years)
Personal Information
Legal Name Family / Last First / Given Full Middle Any Other Names Used
q Miss q Mr.
q Mrs. q Ms.
Chinese Name
(If applicable) / Day of Birth
mm/dd/yyyy
/ / / Place of Birth / Citizenship
q Overseas Chinese student
q Hold valid R.O.C. passport / Passport Number
Current Mailing Address Street/Suite City/Town Province Postal Code / Until
mm/dd/yyyy
/ /
Permanent Mailing Address Street/Suite City/Town Province Postal Code
Marital Status
q Single
q Married / Phone
Home: ( ) -
Work/Cell: ( ) - / E-Mail Address
Past Residence in Taiwan mm/dd/yyyy mm/dd/yyyy
q None q Yes From: / / to / /
Reason for staying in Taiwan: / State of Health
q Excellent q Good q Fair
Taiwan Scholarship/ Huayu Enrichment Scholarship (HES) Award History mm/dd/yyyy mm/dd/yyyy
q None q Yes From: / / to / /
Scholarship Awarded: q Taiwan Scholarship q HES / Chronic Illness
q None
q Yes
Please specify:
Parents Information Father Mother
Name:
Citizenship:
Place of Birth: / Emergency Contact Information
Name: Relationship:
Address:
Tel: E-Mail:
Language Proficiency
Language / Comprehension / Reading / Writing / Speaking
Excellent / Good / Fair / Excellent / Good / Fair / Excellent / Good / Fair / Excellent / Good / Fair
Mandarin
English
Other (Please specify)

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Education Background (Please complete, attach additional sheet if necessary)
Education Level / Name of Institution / Location / Dates Attended
mm / yyyy / Name of Qualifications Granted
Secondary / / / q Incomplete
Post Secondary / / / q Incomplete
/ / q Incomplete
Other
(Please Specify) / / / q Incomplete
PREVIOUS EMPLOYMENT (Attach additional sheet if necessary)
Name of Employer / Organization / Last Job Title / Employment Dates
mm / yyyy mm / yyyy
From: / to /
Work Responsibilities
Name of Employer / Organization / Last Job Title / Employment Dates
mm / yyyy mm / yyyy
From: / to /
Work Responsibilities
PRESENT EMPLOYMENT
Name of Employer / Organization / Last Job Title / Employment Dates
mm / yyyy mm / yyyy
From: / to /
Address Street/Suite City/Town Province Postal Code / Phone and Fax
Phone: ( ) -
Fax: ( ) -
Type of Employer / Organization
q Government Ministry / Agency q Government / State-owned Enterprise q University Institution
q Private enterprise q Joint Venture q NGO q Other (Please Specify)
References
Name / Position / Company
E-Mail or Mailing Address / Phone
( ) -
Name / Position / Company
E-Mail or Mailing Address / Phone
( ) -

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UNIVERSITY Planned to Attend
University:
Department:
Study Plan in Taiwan (Attach additional sheet if necessary)
Applicant’s Certification
I hereby certify that the responses provided on the Huayu Enrichment Scholarship Application Form are complete and true to the best of my knowledge and belief. I understand that providing incomplete, incorrect, or false information may result in the rescission or denial of my award.
Date: Signature:
Office Use Only:
Admission Decision: Comments:

End of Application Form

2016MOE Taiwan Scholarship Application Form 2 Education Division, TECO in Canada