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中國文化大學華語中心

Mandarin Learning Center at Chinese Culture

University

入 學 申 請 表 Application Form

1. 名

 Name

中文姓名  Chinese name (if applicable)

護照上的姓名   Full  name on passport 

2.出生日期

 

 Date Of Birth 3. 性別

  Sex 

年Y／  月M／  日D   □ 男 Male □ 女 Female

4. 護照號碼

  Passport Number  5. 國籍

 

 Nationality

6. 國外通訊地址

 

 Mailing Address in your country 7. 電話

 

Telephone no.

8.!"址

 

 Address in Taian !if applicable"

9.電#$%

 

 #$mail address

10. !&'(%)*+

 

 Person to contact in case of emergency in Taian !if applicable"

姓名  Name  電話  Tel -.   Relationship to applicant 

11./0123文

  %a&e you e&er studied Mandarin before'

  □ Yes12   □  No412 

12.5123文

 

6789:;<

  (f yes) please anser the folloing *uestions+

1. =>?123文 ?  Where did you study Mandarin 12@A  !o" lon# did you study

$. /0B2  M%C 的CDEF GH/   !a&e you ta'en M%C placement test What le&el

13.IJ>KL文MN13O中P

?

 %o did you ,no about M-'+

  □Q+RSTU   FamiliesFriends□VW Teacher□X的1Y chool□Z1[\]^  *#ent 

  □_` Website+,,,,,,,,,  □ab  *d&ertisement□cd -ther :  ,,,,,,,,,,,,,,,,,,,,,,,, 

14.Xef

  ( am applying for 

  □ g+D   ndi&idual Class □ hijG   Ni#ht Class for *RC holders

  □ klD  ntensi&e /roup Class □ cd -thers ______________

15.mn上j日期,

(

klD

)

The term you ish to attend !(ntensi&e group class"  □Jan. ____□Feb. ____ □Mar. ____□Apr. ____□May ____ □Jun. ____ 

□Jul. ____ □Aug. ____□Sep. ____ □Oct. ____ □ Nov. ____□Dec. ____ 

6opefqr   0lease fill in the len#th of classes+

□$ □ □2 □3 □4  □5  □6 □7 □18 "ee's □one semester or more

6s 1t照uvwx?Please pasteone photo

 here.

s t照uyw?n! photo

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z名

 

 Signature日期

 

 Date