APPLICATION FORM
No………./2010
Please complete form in block letters only and submit to The School. Thank you.
01. Family Name (Surname)*
02. Chinese Name (if any)
03. Given (First) Name *
04. Date of Birth* Year Month Day
05. Sex    (Select one) Male
06. Country/Nationality INDIA/INDIAN
07. Passport No. Dated Valid till
08. Place of Birth
09. PAN No. Dated
10. Home & Mailing Address
11. Telephone (Landline)
12. Mobile
13. Email
14. Languages spoken
15. Current Profession
16. Work/Institution address
17. Telephone No.
18. Chinese LanguageCourse
I wish to join (tick one)                       		Express
Express-Business
Express-Travellers
Special Course for Children
Intensive
Special Chinese Classroom
Basic Applied Chinese Language
  *As in passport

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Additional Data required for Special Chinese Language Course
Leading to Medical Major & for Scholarships
19. Student Category (tick as applicable) Special Chinese Classroom & Bachelors* Masters* Doctorate* Non-degree *Scholarship
20. Desired Course/fields
21. Source/s of Support
22. Name of Institution & Qualifications, years studied & highest Degree obtained
High School College
23. Marital Status
24. Data of other family members living with you (Name, age, relationship, profession, mobile no.)
25. Religion
26. Hobbies/Extra Curricular Interests
27. Working Experience
28. References in India & China with Phone No.
29. Application/Processing Fee
30. Amount
31. Cheque data
32. Chinese Proficiency Reading
Speaking
Writing
  (PLEASE NOTE THIS FEE IS NOT REFUNDABLE)
 

I am submitting this Application Form and enclosures after having read and understood all relevant Information. I have attached: 2 passport size and 2 stamp size photographs, Photocopy of Passport & PAN card AND – only for Medical Major Applicants & Scholarships, Photocopies of certificates of Educational Qualifications, Essay (Why I wish to join the Special Chinese Language Course & major in Medicine/desire Scholarship), in apprx. 300 words

  Date Signature