<p> Application Form for 2010 Chinese Bridge for American Schools：A New Start</p><p>Personal Information</p><p>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</p><p>Institution Name: City: State: District: ZIP: Address 1： Address 2：</p><p>Institution Type: □ Elementary School □ Middle School □ High School □ Department of Education □ School District Other( please specify): Institution Sector Type: □ Public □ Private □Religious</p><p>Other( please specify):</p><p>1 Q1 Have you participated in the program before?</p><p>□ Yes. When □ No.</p><p>Q2 Did you receive permission to apply?</p><p>□ Yes. Chief Admin Name: □ No. Chief Admin Email:</p><p>Chief Admin Phone: Q3 Does your school currently offer Chinese Language and/or culture classes? (VERY IMPORTANT)</p><p>If YES, please go to Q8. If NO, please go to Q4.</p><p>If your institution does not teach Chinese</p><p>Q4 Do you have a plan to initiate a Chinese program?</p><p>□ Yes. (Go to Q5) □ No. (Go to Q7) Q5 When do you plan to start the Chinese program?</p><p>□ 2011--2012 □ 2012--2013 □ 2013--2014</p><p>Q6 What makes you think is necessary to start a Chinese program?</p><p>Please specify: Q7 Which of the following do you think will be critical in the process of initiating a Chinese program</p><p>□ Teaching-Learning Materials □ Guest Chinese Teachers □ Chinese Reference Books □ Audio-Visual and Books Introducing China and Chinese Culture</p><p>Other (please specify):</p><p>If your school/district already has a Chinese program:</p><p>Q8 In what grades do you offer Chinese classes in your school/district? □ K--6 □ 6--9 □9--12</p><p>Q9 How many students currently enrolled in your Chinese classes? </p><p>Q10 In what ways are the Chinese classes offered?</p><p>□ A formal part of the curriculum □ After school/ Interest Class</p><p>2 Q11 The Chinese teachers in your school are: </p><p>□ Full-time teacher □ Part-time teacher </p><p>□ Guest teachers from Hanban-Collegeboard Program</p><p>□ Local teachers certified in teaching Chinese as a second language</p><p>□ Local teachers graduate from a degree program</p><p>Other (please specify):</p><p>Q12 What are the special features of Chinese classes in your school? </p><p>□ Immersion Program □ Guest Teachers □ Student trips to China</p><p>□ Staff Exchanges □ Pen/E-pal program □ Online Initiatives</p><p>□ After-school Activities □ Culture-based Activities □ Partnerships with Other Institutes</p><p>Other (please specify):</p><p>Q13 Which of the following will be helpful to enhance and expand your program?</p><p>□ Teaching-Learning materials □ Chinese reference books </p><p>□ Guest Chinese teachers □ Professional development opportunity for the teachers</p><p>□ Audio-visual and books introducing China and Chinese culture Other (please specify):</p><p>Q14 Do you have any existing partnerships in China?</p><p>□ Yes. Listing the name(s): □ No.</p><p>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.</p><p>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.)</p><p>4</p>