BEIJING LANGUAGE AND CULTURE UNIVERSITY APPLICATION FORM FOR INTERNATIONAL STUDENTS

Very Important: If the form is not filled in on a computer, please write legibly in black or blue ink. Please fill every section of the form. /Family name Name on Chinese name /Given name passport Photo Nationality Place of birth Male Date of birth YY-MM-DD: Female Married Single Passport No. Religion Current or latest /Highest education occupation / Current or latest school or employer /Full non-Chinese permanent postal address:

/Tel: /Fax: E-mail: /Address to receive the admission package, if different from above: /Tel: /Fax: E-mail: /from /Y /M /D /to /Y /M /D Intended program at BLCU / Tick the appropriate box to indicate the number of Chinese words you know. A None B about 800 C about 1500 D about 2500 E about 3500 F about 4000 ABCD /The Intensive Program is offered only to students in Chinese level A, B, C and D

/Program applied for: /Non-degree courses

/Short Term Programs(1 semester or less) 20 // Regular course20hrs/week30 // Intensive course30hrs/week /Long Term Programs(at least 1 academic year) /Chinese Language Student /General Scholar Student /Senior Scholar Student /Teachers Training Programs

()/Curriculum vitaeStarting from high school // Previous and current educational institute & employer years attended (from/to)

Position

/Family members / Name / Relation

/ Tel.

, Emergency contact (Can be a parent or relative of the applicant, out of China, or in China. Student cannot be the contact) / Name: / Nationality: /Relationship to the applicant:

/Permanent Mailing Address:

/ Name of employer: /Tel: (/home) / Fax: E-mail: (/office)

1. 2. 3. 4.

I am willing to study at Beijing Language and Culture University. I pledge the following terms during my study:
1. I will abide by the laws of the Peoples Republic of China. 2. I will not engage in activities bearing no relation with my academic pursuit in China. 3. I will study industriously and observe all rules and regulations of the University. 4. I will pay all expenses on time. /Signature of the applicant:

Date:

1. JW202
2. 3.

Notes: 1. The University will send the Admission Notice and Form JW202 (for visa) out to the applicant three weeks after
receiving the application. 2. Application materials sent by fax are unacceptable. Application documents and application fees will not be returned. 3. Each application is valid for one session of study. Those who wish to join more than one sessions must submit application documents separately (The Form can be copied).

Accommodation
Accommodation Types

Host Family On-campus Single Room On-campus Shared Room On-campus Economic Double Room Student Residence (Single) Student Residence (Double) Standard Apartment (Private) Standard Apartment (2 bedroom) Standard Apartment (3 bedroom) Hotel

Accommodation Start (day before start of program) Accommodation End (day after the last day of program) For shared accommodation: Do you smoke? Do you prefer to live in a smoke-free room? For Host Family Only: Allergies, Special Medications, Etc. Yes / No Yes / No

Signature of the applicant: Date: