APPLICATION FORM

INTERNATIONAL CHINESE LANGUAGE PROGRAM
NATIONAL TAIWAN UNIVERSITY
APPLICATION FOR ADMISSION TO 2015 SUMMER PROGRAM
APPLICATION FORM
(Please Type or Write Legibly in Block Letters)
I.
PERSONAL DETAILS
Full Name*
(first name)
(middle name)
(last name)
*Please make sure that this is identical to your passport name.
Chinese Name*
(in traditional characters)
*Your Chinese name will appear on your Student ID so please make sure that it is correct.
Nationality
Date of Birth
Passport Number
(Date)
(Month)
Telephone Number
(Year)
Email
Mailing Address*
*Please provide your address in details, including postcode and country.
Permanent Address*
*Please provide your address in details, including postcode and country.
Marital Status
II.
Single □
Married □
Will your family accompany you?
Yes □
No □
CURRENT EDUCATION STATUS
(degree)
Most Recent Degree
(major/subject)
(university)
(year of graduation)
(degree)
Now pursuing
(major/subject)
(university)
(expected graduation year)
III.
If applicable, provide dates, length of stay and purpose of residence in any Chinese-speaking countries:
Taiwan
PRC
Others
IV.
If you have worked/are working full-time, what was/is your occupation?
1
V.
LANGUAGE BACKGROUND
□ I am a complete beginner in Chinese language.  Please skip to VI.
□ I am not a beginner in Chinese language.  Please answer the questions below.
Year you began Chinese language study
Where?
Chinese language course(s) completed
(Course Name)
(No. of Semesters/Quarters)
(Where)
(When)
What is your native Language?
Other Language(s)?
VI. REFERENCES
(1)Name
Email
(2)Name
Email
VII. MY STUDY PLAN
□ I intend to attend the Summer 2015 Program only.
□ I intend to continue into the 2015-2016 Academic Year Program for three more quarters ending on May 27,
2016.
VIII. CHECKLIST
□ Application form
□ Non-refundable application fee US$100
□ Two photos. Please make sure that they are clear, color headshots. Please put down your name on the
back of the photos.
□ Or, one digital photo sent via email on
(date)
(month)
(year)
□ Statement of purpose
□ Transcript
□ Two reference reports
□ I understand that my application will not be processed until all the materials above are submitted in full.
□ I understand that the tuition fee for the 2015 Summer Program is US$4,200 and the tuition fee for the
2015-2016 Academic Year Program is US$12,100.
□ (applicable to the Ministry of Education Scholarship recipients) I understand that the Huayu Enrichment
Scholarship or Taiwan Scholarship does not cover my entire tuition fee and I will be able to finance myself
while studying at ICLP.
Signature: _______________________
Date: ______________________
2
REFERENCE REPORT 1
Name of Applicant
Name of Evaluator
How long and in what capacity
have you known the applicant?
TO THE EVALUATOR: The above-named applicant is applying for admission to intensive language study
at ICLP. Your candid evaluation of the applicant will be of great help. Please comment on the applicant’s
intellectual ability, academic achievement, maturity and emotional stability, initiative, oral and written
communication, strengths and weaknesses. You may add a personal letter on behalf of the applicant if you
wish.
Evaluator’s Signature
Date
Evaluator’s Position or Title
Evaluator’s Affiliation
Evaluator’s Telephone No.
Evaluator’s Email
Please return this reference report to the applicant in a sealed envelope with your signature across the flap or mail it
directly to International Chinese Language Program, Language Center, National Taiwan University, Office 420,
170 Xin-Hai Road, Section 2, Da-An District, Taipei 10663, Taiwan by March 31, 2015.
3
REFERENCE REPORT 2
Name of Applicant
Name of Evaluator
How long and in what capacity
have you known the applicant?
TO THE EVALUATOR: The above-named applicant is applying for admission to intensive language study
at ICLP. Your candid evaluation of the applicant will be of great help. Please comment on the applicant’s
intellectual ability, academic achievement, maturity and emotional stability, initiative, oral and written
communication, strengths and weaknesses. You may add a personal letter on behalf of the applicant if you
wish.
Evaluator’s Signature
Date
Evaluator’s Position or Title
Evaluator’s Affiliation
Evaluator’s Telephone No.
Evaluator’s Email
Please return this reference report to the applicant in a sealed envelope with your signature across the flap or mail it
directly to International Chinese Language Program, Language Center, National Taiwan University, Office 420,
170 Xin-Hai Road, Section 2, Da-An District, Taipei 10663, Taiwan by March 31, 2015.
4