The Beijing Center

Personal Information

 
* 1. First Name:
 
* 2. Last Name:
 
  3. I prefer to be known as:
 
* 4. Gender:
   
 
* 5. Class of
 
* 6. Age:
 
* 7. Date of Birth(MM/DD/YY):
 
* 8. Email address:
 
* 9. Home University/College:
 
* 10. Major:
 
  11. Minor:
 
  12. My interests/hobbies include:
 
* 13. I am enrolled at TBC for:
 
Circle the answer which best describes you:
 
* 14. I am:
   
 
* 15. I prefer to go to sleep:
     
 
* 16. I smoke:
   
 
* 17. I prefer to live with a non-smoker:
   
 
* 18. I exercise regularly:
   
 
* 19. I prefer having:
   
 
* 20. I drink alcohol:
     
 
* 21. I speak Mandarin:
     
 
Page 1 of 2