<p>申請表(Application Form)</p><p>International Student Application Form (p.1/3) Chinese Seasonal Course Chinese Language Center 華語文中心 Instructions </p><p>PASSPORT PHOTO</p><p>● Please complete this form in BLOCK LETTERS in English ● Read and SIGN the conditions of enrolment ● Mark relevant boxes with an X ● My application is through a representative: □No □Yes ● Please fill out the form and send it with the rest of the application materials to the below address or by e‐mail ● Return to: No.1 Syuecheng Rd.,Sec. 1, Dashu Dist., Kaosiung City 84001,Taiwan R.O.C. Chinese Language Center E-mail: [email protected]</p><p>Family Name: Given Name: Chinese Name:</p><p>Gender Date of Birth Nationality □Male □Female /(D) /(M) /(Y) Emergency contacts: Mobile: Passport Number: Relationship:</p><p>E-mail: Name:</p><p>Mobile: Address for correspondence :</p><p>Do you take any medication or have a medical condition? □Yes □No If yes, please details ______Education Background Highest Education：□Senior High School □University □Master Degree □Ph.D Degree School Name: ______Major: ______Graduated : □Yes □No Language Background (1) Have you ever studied Mandarin before? □ Yes □ No (2) Where did you learn Mandarin? □ Taiwan □ Mainland China □ In your own country □ Other ( ______)</p><p>International Student Application Form (p.2)</p><p>Language Background (3) Please mark your Mandarin level □ Basic (less than 1 year) □ Intermediate (about 1-2 years ) □ Advanced (more than 3 years ) (4) Which have you studied? □ Zhuyin □ Pinyin □ Simplified Characters □ Traditional Characters CLC Seasaon Course Selection Level: □Beginner □Basic □Intermediate</p><p>Year: 20 Month/Season: □Mar‐May/Spring □Jun‐ Aug/Summer □Sept‐ Dec/Fall □Dec-Feb(Mar)/Winter</p><p>Do you intend to continue your studies at I-Shou University after completion of your Chinese language course? □Yes □No If yes, have you already submitted an application to ISU Office of International & Cross-Strait Affairs? □Yes □Faculty______□No</p><p>Conditions of enrolment and declaration  I understand that I must graduate from high school at the time of course beginning.  I understand and accept the terms of the CLC refund/cancellation policy.  I understand that I must complete all class work, assignments, activities and assessments in order to maintain satisfactory progress.  I understand that I must attend at least 85% of my course and that if I am studying on a Visitor Visa (with Chinese Language Study as the reason).  I understand that ISU‐CLC reserves the right to defer, temporarily suspend, or cancel my enrolment for misbehavior.  I understand that I change my address of accommodation in Taiwan I must notify ISU‐CLC within three working days.  I agree that ISU‐CLC can share information about my course and progress with my university or college, my sponsor or educational representative.  I understand that I am fully responsible for my educational and living expenses while studying at ISU‐CLC.  I acknowledge that ISU‐CLC has the right to change its fees and conditions, cancel or defer courses, and to alter course timetables and class locations at any time without notice.  I understand that by providing my personal email address on this application form I am giving permission to ISU‐CLC to use this to communicate with me on any matters relating to my enrolment at ISU‐CLC.  I agree to abide by the regulations of ISU‐CLC and I‐ Shou University.  I understand that more information about my student rights and responsibilities under the Regulations Regarding International Students Undertaking Studies in Taiwan is available online at law.moj.gov.tw/Eng/news/news_detail.aspx?id=3619</p><p>Checklist of required documents  Application form (including study plan).  1 passport photo  Photocopy of diploma or photocopy of official school transcripts .  Photocopy of passport first page (must clearly show passport number, name, personal data and photograph).  Recent financial statement within 3 months proving the applicant has at least US$2,000.</p><p>Dormitory required  Yes, please arrange a 4-person shared room for me. (9,300 NTD per term)  Yes, please arrange a single room for me.( (42,000 NTD per term)  No, I don’t need accommodation. </p><p>Study plan: ______</p><p>The information contained in this form will be basis of university record, please fill it in clearly and correctly. I-Shou University reserves the right to computerize and utilize your personal information for administrative purposes.</p><p>Applicant’s signature: ______Date: ______Chinese Language Center of I-Shou </p>