Global China Connection-Apply now

If you prefer, feel free to print out a hard copy Application Form, fill it out and mail along with your application fee to our US office, or scan a copy and email it to inquiry@globalchinaconnection.com.

PERSONAL INFORMATION:

First Name:	*	Last Name:	*
Address:	*
City:	*
State (if US):		Country:	*
State or Region If Outside US:	*	Zip code:	*
Home Telephone: (with country code) :	*
Cell Phone:	*
Email address:	*	Confirm Email Address:	*
Gender:	*	Date of Birth:	*
Place of Birth:	*	Passport Number:	*
Passport Valid Until:	*	Nationality (Citizenship):	*
Marital Status:		Religion:

Name of School or University Currently Attending:
Current Employment:
Employment History (Job Title, Employer, Dates of Employment):
In the Space Provided, Feel Free to List Any Additional Information About Yourself:

PARENT/GUARDIAN INFORMATION (If under 18, please have a parent or guardian answer the following):
First Name:		Last Name:
Relationship to Applicant:		Email Address:
If different from applicant, please fill out the following:
Street Address:		City:
State (if US):		Country:
State or Region If Outside US:		Zip code:
Home Telephone: (with country code) :
Cell Phone:
In the Space Provided, Feel Free to List Any Additional Information About Yourself:

EMERGENCY CONTACT INFORMATION (If under 18, feel free to include a secondary contact different from the parent/guardian information.):
First Name:	*	Last Name:	*
Relationship to Applicant:	*	Email Address:	*
Street Address:	*	City:	*
State (if US):	*	Country:	*
State or Region If Outside US:	*	Zip code:	*
Home Telephone: (with country code) :	*
Cell Phone:

CHINESE EXPERIENCE:
Have You Traveled to China Before?	Yes No
What Areas Have You Visited?
Have You Studied Chinese Before?	Yes No
(If yes, please answer the following)
How Long Have You Studied Chinese?
Study Method?	High School Course College Course Private Tutor Self Study Other
Please Elaborate:
Approximately How Many Characters Can You :	Recognize Write Speak
Please Elaborate on Your Chinese Speaking Ability and Listening Comprehension:

PROGRAM:
City:	*
Program Selection:	*
Program Duration:	*
Program Start Date:	*
Program End Date:	*
Are You Interested in Being Considered for an Internship?	Yes No
How Long Would You Like Your Internship To Last?
(If Internship Program is selected, please remember to send us a resume and cover letter immediately after submitting this form.)
ACCOMMODATION:
Accommodation Choice:	*
Accommodation Start Date:	*
Accommodation End Date:	*
Preferred LocationPreferred Location:	Near Campus Downtown Other
If Other, Please Specify:
Do You Smoke?	Yes No
Do you prefer to live in a non-smoking room?	Yes No Doesn't Matter
Do You Have Any Health Problems or Concerns? If So, Please Elaborate :
Additional Comments:
If you have chosen homestay, please answer the following
Do You Mind a Family With Small Children?	Yes No
Do You Mind a Family With Pets?	Yes No
Do You Have Any Dietary Restrictions or Preferences? Please Elaborate:
Please Indicate a Few of Your Hobbies or Special Interests and Preferred Lifestyle. We Will Try to Match These with Your Accommodation:
Please indicate a few of your hobbies or special interests and preferred lifestyle. We will try to match these with your accommodation :

ACTIVITIES & ELECTIVES(Selections are optional, and may incur additional fees):
Choose Activity #1:
How Many Times per Week:
How Many Hours per Class:
Indicate Your Experience Level:		Beginner Intermediate Advanced
Please Elaborate:
Other Comments:
Choose Activity #2:
How Many Times per Week:
How Many Hours per Class:
Indicate Your Experience Level:		Beginner Intermediate Advanced
Please Elaborate:
Other Comments:
Choose Activity #3:
How Many Times per Week:
How Many Hours per Class:
Indicate Your Experience Level:		Beginner Intermediate Advanced
Please Elaborate:
Other Comments:
HOW DID YOU HEAR ABOUT US:
Method:		*
Details:		*
ADDITIONAL COMMENTS:
Please include any additional information you feel we should be aware of (i.e. Joint Application - state name of joint applicant, etc.):
We recommend you print a copy of this form for your reference. We will contact you to confirm this information, and request payment of the $75 non-refundable application fee after submission. Please contact us at inquiry@globalchinaconnection.com with any questions or problems.
APPLICANT SIGNATURE:
I declare that: The above information provided and documents given in support of my application are complete, true, and correct. I agree to abide by the laws of the People's Republic of China and agree not to engage in any illegal activities during my academic pursuit in China. I have read and accept GCC's Terms and Conditions for program participants. I agree to observe and accept all rules, regulations, and conditions of the host schools / institutes / organizations.

I agree with the declarations above: Yes No
Electronic Signature of Applicant (Please Type Full Name): *
If Under 18, Please Have Parent/Guardian Sign: