Chinese Passport Application Form

							                                               Study Abroad In China                            Accredited Program & Quality Service
                                                                                     Mandarin - Acupuncture - Tuina - Cupping - Martial Arts Programs



                                                              Application Form
1. Applicant’s Information
Given Name:                           Middle Name:                            Family Name:                         Date of Birth:

Chinese Name*:                        Gender:                                 Marital Status:                      Place of Birth:

Street:                                                                                                            Country:

City:                                 State:                                  Zip code:                            Email:

Telephone:                            Mobile Phone:                           Last School Name/Location:

Nationality:                          Passport Nõ:                            Current Occupation:                  Last Degree:

Hepatitis B:                          Tuberculosis:                           Allergy:                             Other Infection:

2. Program

Program Applying:                Mandarin                    Traditional Chinese Medicine               Martial Arts           Cantonese

Program Location:           Guangzhou                  Beijing            Shanghai
Program Name(Quote from website):

Program Start Date:                              Program End Date:                              Program Length(Year/Semester/Week):

Accommodation Type:                   Application Fee: USD                    Program Fee: USD                     Total Fee: USD

For Martial Arts, please specify preference of forms for training:

3. Past Mandarin / TCM / Martial Arts / Cantonese Study Experience
Dates:                            Name of Institution:                             Total Hours Per Week:                       Level:

I know approximately              0                   300               800                 1500            2500              3000      Chinese words.
Other Study In China Experiences

Dates:                            Name of Institution:                             Hours Per Week/Total weeks:         /       Level:

4. How Did You First Hear About Allied Gateway
Internet: www.                                                                     Magazine:

Education Fair:                                                                    Other:

5. In Case of Emergency, Notify
Name:                                     Relationship (e.g. Father):                                              E-mail:

Telephone:                                Fax:                                     Address:
With my manual signature below, I hereby confirm that:
1) I register the above program with Allied Gateway; All Information and documents given by me are true and correct;
2) I am personally responsible for all consequences arisen by any of my violation to China Laws, school regulations and Allied Gateway's Terms
and Conditions;
3) I am responsible for any of my medical/accidental emergency during my stay in China for the above program, if there is any.



Applicant Manual Signature *: ________________________                   Date (yyyy/mm/dd): _________________
* This application form requires applicant's manual signature; Also, if you have a Chinese name, fill it in related column in Chinese words.


                                                            Beijing • Shanghai • Guangzhou
                                                                www.StudyInChinaCourse.com
                                            Study Abroad In China                           Accredited Program & Quality Service
                                                                                Mandarin - Acupuncture - Tuina - Cupping - Martial Arts Programs



 6. Important Information:
* Please directly tick and type in information in each blank on this form, then make a manual signature after printing.

* All information required in this application form is strictly kept in confidential and used on purpose of program registration only.

* After completion, please scan and return this application form by email along with below documents: (Please make all files smallest possible but

  clearly readable)

  + A passport copy of the page with your photo, birthday, passport number, expiring date;
  + A digital passport photo;
  + A copy of your previous education certificate (latest transcript accepted for those who are currently student);
  + Copy of bank telegraph transfer receipt for application fee.
* Application fee:

  + Application fee for TCM Programs is USD300;
  + Application fee for programs other than TCM Programs is USD100;
  + Bank transfer charges outside China to be paid by applicant;
  + Our bank information available upon request.
* Your program reservation will be effected upon your application fee received in our bank account; A notice email will be sent to you within 24

  hours.

* An Admission Letter and an Enrollment Letter will be sent out to you by email within 3 working days upon your application fee received in our

  bank account;

* Visa supporting documents will be sent out to you by registered mail in 2 working days upon the balance of total program fee received in our

  bank account.




                                                       Beijing • Shanghai • Guangzhou
                                                           www.StudyInChinaCourse.com