Confucius Institute at Cleveland State University 2015 年体验中国 .PDF

Confucius Institute at Cleveland State University 2015 年体验中国暑期项目申请表 Application for 2015 Study Abroad in China Summer Program 英文姓名Family Name (Last Name): First Name Middle Name: 中文姓名Chinese Name: 性别Gender 国籍Nationality: 出生日期Date of Birth: 出生地点Country of Birth: 年(Y) 月（M ） 日(D) 电子邮件E-mail Address: 护照号码Passport No: 护照有效期Passport Valid Until: 年/Y 月/M 日/D 学习单位University Name (where you are a student): 学习专业Major at Your University 所在国地址Permanent Home Address and Telephone No. 街道Street_______________________________________________城市City______________________ 国家Country_________________邮编ZIP code_____________ 电话Phone Number________________ 家长或紧急联系人地址及联系方式Parents’/Emergency Contact’s Mailing Address: 街道Street_______________________________________________城市City______________________ 国家Country_________________邮编ZIP code_____________ 姓名Name________________ 电话Phone Number______________ 关系Relationship ______________ 姓名Name________________ 电话Phone Number______________ 关系Relationship ______________ 最高学历Highest Academic Degree Obtained: Submission Deadline: Friday, January 30, 2015 申请人在递送本申请表时请提交： Applicant should submit the following documents with the application form: (1) 护照复印件 Photocopy of passport photo page (2) 报名费 ：200 美元 Registration Fee: $200, checks payable to The CSU Foundation, memo: Confucius Institute Study Abroad (3) 教授推荐信Recommendation letter from a professor (4) 非正式成绩单Unofficial transcript Please send the application form and registration check to: The Confucius Institute Cleveland State University 2