(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 CodeMailing 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:______
Emergency Contact Person
Full Name (in Chinese) / Full Name (in English)
Family Name / Given Name(in full)
Relationship / Telephone Number / Cell PhoneNumber
E-mail Address / Postal CodeMailing Address
Do you need special care during your stay at NCCU?
□Yes. Please specify: ______
□No.
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
Course Selection
Chinese Language Program (Fee-Paying)
Course Title / Class Time / Class Day / Class Date
□ / Chinese Language Study (USD 590) / 1:10 p.m. – 4 p.m. / Mon. – Thu. / July 06 –August 13
EnglishInstructedCourses (Tuition Waived)
□ / Sustainability in Taiwan and East Asia / 9 a.m. – 12 p.m. / Mon. – Wed. / July 07– July 15
□ / Societies, Cultures, and Politics of East Asian / 9 a.m. – 12 p.m. / Mon. – Wed. / July 07– July 15
□ / Culture, History, and Politics of Art in Taiwan / 2 p.m. – 5 p.m. / Mon. – Wed. / July 07– July 15
□ / Cross-Strait Enterprise Development / 2 p.m. – 5 p.m. / Mon. – Wed. / July 07– July 15
□ / Hindsight and Foresight: Economic Development in Taiwan / 9 a.m. – 12 p.m. / Mon. – Wed. / July 20– July 29
□ / Knowledge-based Economy and Multiculturalism / 9 a.m. – 12 p.m. / Mon. – Wed. / July 20– July 29
□ / Innovation Management and Entrepreneurship / 2 p.m. – 5 p.m. / Mon. – Wed. / July 20– July 29
□ / Principles of Management: The Asian Perspective / 2 p.m. – 5 p.m. / Mon. – Wed. / July 20– July 29
*When choosing the courses above, please make sure that you do not have any timetable conflicts.
*Please attend the Orientation: 10 a.m. / Monday, July 6, 2015 / Conference Room No.1, 7F of Admin. Bldg.
Registration Fee
USD 160 (non-refundable)
Accommodation
□I will take care of my accommodation in Taiwan.
□I need information about the application for the summer accommodation.
*The available rooms will be assigned on a first-come, first-serve basis. Theapplicant will be informed by e-mail if all of the rooms are filled.
Admission Letter
□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,April13th, 2015.
※Based on limited campus facilities and academic support resources, we reserve the right to admit or decline students.