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Personal Information
First Name
Last Name
Date of Birth
Nationality
Citizenship
Gender
Phone Number
Email
Chinese Level
Medical Insurance Carrier
Policy number
List all allergies including medicine
Any history of illness
Permanent Address
Street and number
City
State/providence
Zip/postal code
Country
School Information
School Name
School Address
School Phone
Expected Graduation Date
Parent/Guardian Information (if applicant is under 18)
Full Name
Relationship to applicant
Address
Email
Phone
Secondary Phone
Fax
Program Information
Are you coming as an individual student or a group?
  Individual  Group
Supplemental Information
Please describe what goals you hope to accomplish during your time in China
 
   

Have you ever traveled abroad before?  Where?  For what reason?

 

Are there any special arrangements you would need or like to make while in China due to medical or personal reasons?

 
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