Application Form for 2010

Application Form for 2010 Chinese Bridge for American Schools：A New Start

Personal Information

Title: □ Mr. □ Ms. □ Mrs. Name: First Name: Middle Name: Last Name: Position: Passport Number: Country/Authority that Issued Passport: Passport Expiration Date: Contact Information Office Phone Number: Fax: Address 1: Address 2: Home Phone Number: Address 1: Address 2: City: State: ZIP: Institution Information

Institution Name: City: State: District: ZIP: Address 1： Address 2：

Institution Type: □ Elementary School □ Middle School □ High School □ Department of Education □ School District Other( please specify): Institution Sector Type: □ Public □ Private □Religious

Other( please specify):

1 Q1 Have you participated in the program before?

□ Yes. When □ No.

Q2 Did you receive permission to apply?

□ Yes. Chief Admin Name: □ No. Chief Admin Email:

Chief Admin Phone: Q3 Does your school currently offer Chinese Language and/or culture classes? (VERY IMPORTANT)

If YES, please go to Q8. If NO, please go to Q4.

If your institution does not teach Chinese

Q4 Do you have a plan to initiate a Chinese program?

□ Yes. (Go to Q5) □ No. (Go to Q7) Q5 When do you plan to start the Chinese program?

□ 2011--2012 □ 2012--2013 □ 2013--2014

Q6 What makes you think is necessary to start a Chinese program?

Please specify: Q7 Which of the following do you think will be critical in the process of initiating a Chinese program

□ Teaching-Learning Materials □ Guest Chinese Teachers □ Chinese Reference Books □ Audio-Visual and Books Introducing China and Chinese Culture

Other (please specify):

If your school/district already has a Chinese program:

Q8 In what grades do you offer Chinese classes in your school/district? □ K--6 □ 6--9 □9--12

Q9 How many students currently enrolled in your Chinese classes?

Q10 In what ways are the Chinese classes offered?

□ A formal part of the curriculum □ After school/ Interest Class

2 Q11 The Chinese teachers in your school are:

□ Full-time teacher □ Part-time teacher

□ Guest teachers from Hanban-Collegeboard Program

□ Local teachers certified in teaching Chinese as a second language

□ Local teachers graduate from a degree program

Q12 What are the special features of Chinese classes in your school?

□ Immersion Program □ Guest Teachers □ Student trips to China

□ Staff Exchanges □ Pen/E-pal program □ Online Initiatives

□ After-school Activities □ Culture-based Activities □ Partnerships with Other Institutes

Q13 Which of the following will be helpful to enhance and expand your program?

□ Teaching-Learning materials □ Chinese reference books

□ Guest Chinese teachers □ Professional development opportunity for the teachers

□ Audio-visual and books introducing China and Chinese culture Other (please specify):

Q14 Do you have any existing partnerships in China?

□ Yes. Listing the name(s): □ No.

Q15 Do you think participating in this Chinese Bridge program will contribute to the development of Chinese program at your institute? □ Yes. Please specify: □ No.

3 Personal Statement Please let us know your thoughts and reasons for wanting to attend this program (if not enough space, attach extra pages freely.)