The Beijing Center

Application Form

(There are 3 parts to this application)

PART I. APPLICANT INFORMATION

 
  1. If you have read the eligibility criteria for Priority Admission and feel that you are qualified, please identify the criteria:
   
 
 
* 2. I am applying for:
 
* 3. First Name:
 
  4. Middle Name:
 
* 5. Last Name:
 
* 6. Gender:
 
 
 
  7. Preferred Name:
 
* 8. Present (Campus) Address:(Street Address/City/State/Province/Zip/Valid until)
 
* 9. Telephone
 
* 10. Cell Phone
 
* 11. E-mail Address
 
* 12. University/College Attending
 
* 13. Major / Minor
 
  14. Work experience
 
  15. Foreign language skills
 
  16. Previous travel experience
 
* 17. Citizenship
 
* 18. Birth Date
 
* 19. Birth Place (City / State or Country)
 
* 20. At this time, do you have a passport that you plan to use to go to China that is valid at least six months beyond the ending date of your intended stay in Beijing?(If no, please apply for a passport or get your current one renewed as soon as possible.)
 
 
 
  21. If yes, what is the Passport Number?
 
  22. Passport Expiration Date?
 
* 23. Permanent Address:(Street Address/City/State/Zip/Country/Telephone)
 
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