Application Form of International English-Speaking Program Admission

CHINESE CULTURE UNIVERSITY

APPLICATION FORM OF INTERNATIONAL ENGLISH-SPEAKING PROGRAM ADMISSION (Scholarship available) Spring/Fall Semester 2015 Attach two recent photographs here (about 1〞x 2〞) TO THE APPLICANT: Read carefully and complete in type or clear handwrite. 1、 Personal Data： ● Full name (in Chinese)：______

● Full name (in English)：______(Last) ______(First) ______(Middle)

● Full name (in own language)：______(Last) ______(First) ______(Middle)

●Home address：______

●Mailing address: ______

●Name and address of legal guardian：______

●Nationality：______●Place of birth：______

●Date of birth：____ /Year ___ /Month ___ /Day ●Gender：□ Male □ Female

●Passport no.：______●ID (Social security) no.：______

●Email：______

●Phone no.：______●Mobile phone no.：______

●Father’s Name：______●Mother’s Name：______

●Father’s Nationality：______●Mother’s Nationality：______

●Father’s Occupation：______●Mother’s Occupation：______

2、 Educational Background：

Degree College or University Item Name of school

City and country

Degree conferred

Student identification no.

Duration (from/to)

3、 Proficiency in English Language： 1 Excellent Good Fair Poor Listening Speaking Reading Writing

Please indicate the following information: TOEFL SCORE ( 64 ibt or above):______；TOEIC SCORE (650 or above)：＿＿＿_；IELTS SCORE(5.5 or above) ：＿＿＿

4、Program intend to study with scholarship opportunity： Degree Programs (Taught in English):

□ Master program in English Language and Literature □ Master program in Earth Sciences (Available in Fall semester only) □ English Master’s Program of Global Business (GMBA) □ PHD in Business Administration (Available in Fall semester only) □ English Undergraduate Program of Global Business (Available in Fall semester only) □ Master program in Sport Coaching Science □ Master program in China Studies (Available in Fall semester only)

5、 Health Condition：If you have any health problems, please describe them below:

6、Previous Paid Employment：

7、Scholarship information: Each academic year, CCU offers scholarship and assistantship opportunities for international students with academic potentials. 1. Scholarship and assistantship with service hours ( postgraduate students only) 2. Taiwan government scholarship 3. Other sponsorship ( with evidence) Declaration 1. I certify that I hold no status as an overseas Chinese, nor am I a citizen of the Republic of China. 2. I certify that I have not been a citizen of the Republic of China in the last eight years. This covers the period between the day of annulment of my citizenship of the Republic of China as approved by the ROC Ministry of Interior and the first day of a new semester at the Chinese Culture University. 3. I have not applied to other universities under the status of an overseas Chinese. 4. The certificate of the highest education from home country provided by me is legally acquired and effective, and the graduation certificates of all levels are equivalent to the respective levels of education in the Republic of China. 5. I have not completed any application process for study at nor have I been expelled from other universities. 6. I agree to authorize your university to check all items mentioned above, and I have no objections as to regulations set forth by the admission committee of CCU for foreign students. Signature of applicant：______Date：______

2 Items of Submission

(Please tick the items that you have submitted)

No Items you should hand in Piece(s) Check here 1 Two application forms 2 2 Certificate stating that the applicant who has had or once had dual nationality has lost 1 his/her citizenship to the Republic of China. 3 Certificate of the highest education diploma notarized and stamped by the foreign 1 representative office of the Republic of China (those in languages other than Chinese and English should be translated into Chinese or English and notarized). 4 Transcripts of the highest education diploma notarized and stamped by the foreign 1 representative office of the Republic of China (those in languages other than Chinese and English should be translated into Chinese or English and notarized). 5 Two recommendation letters 2 6 Financial statement notarized and stamped by the foreign representative office of the 1 Republic of China showing sufficient financial support for education and living expenses for study in Taiwan, Republic of China. 7 Proposal or study plan for research culminating in a degree. 1 8 Certificate of English Proficiency (TOEFL/IELTS/TOEIC) 1 9 A published academic paper: this applies only to applicants for the Ph.D. Program. 1 10 Certificates of outstanding performances. 1 11 Two recent photographs （1”×2”） 2 12 One photo copy of the passport page bearing the name and nationality of the holder. 1 13 The Receipt of Application fee (NT$ 2,500/US$85 for Doctoral Degree Program, 1 NT$1,300/US$45 for Master’s Degree Program and NT$ 1,200/US$40 for Undergraduate Program).

Full name (in English)：______(Last) ______(First) ______(Middle)

Signature of applicant：______