INFORMATION COLLECTION FORM

HAOYUN INFORMATION COLLECTION FORM

I. PACKAGE CHOICE AND DEGREE SELECTION


Choose Package

(Select one) *
What degree are you applying for?

(Select one) *
If applying for Scholarship, please choose which scholarship

(Select one) *

II. BASIC INFORMATION


Full Name (As written on your passport) : *
Passport Number *: Passport Date of Issue *: Passport Expiration Date *:
Telephone Number (Whatsapp) *:
Gender *:
Marital Status *:
Nationality *:
Birth date *: Place of Birth (Province, City) *: Native Language *:
Highest Level of Education *:
Primary Email Address *:
Back up email address (If any) *:
Religion *: Occupation *: Current School / Institution *:
Medical History *: Emigrant from mainland China, Hong Kong, Macau, and Taiwan

*

:
Foreign Citizen of Chinese Origin? *

III. LANGUAGE PROFICIENCY


English Proficiency: *:
Have you passed any written Proficiency exams? : *:
Other Language Proficiency: *:
Chinese Proficiency: *:
HSK Level: *:
HSK Score: *:

IV. STUDY EXPERIENCE (highest diploma must be included)


Year Attended (From) - Year Attended (To) : *
Name of School : *
Degree Level : *
Discipline category : *
Year Attended (From) - Year Attended (To) :
Name of School :
Degree Level :
Discipline category :

WORK EXPERIENCE


Year Attended (From) - Year Attended (To) : *
Company : *
Title : *
Occupation : *
Year Attended (From) - Year Attended (To) :
Company :
Title :
Occupation :

FAMILY MEMBERS


Relationship : *
Name : *
Occupation : *
Email or Phone Number : *
Relationship :
Name :
Occupation :
Email or Phone Number :

VII. GUARANTOR


Guarantor Name (In English) : *
Guarantor Tel # : *
Guarantor Address : *
Relationship with You : *
Email : *

VIII.EMERGENCY CONTACT


Name : *
Phone Number : *
Working Organization : *
Mobile : *
Email : *
Address : *

IX. HOME COUNTRY ADDRESS


Street Address : *
Province & City : *
Country : *
Zip code : *
Phone number : *

IX. ACCOUNT INFORMATION


Photo ID : *
NAME : *
Email : *
Password : *