If you prefer, feel free to print out a hard copy Application Form, fill it out and scan a copy and email it to inquiry@globalchinaconnection.com.
 PERSONAL INFORMATION:
First Name: * Last Name: *
Country: *
Home Telephone: (with country code) : *
Cell Phone: *
Email address: * Confirm Email Address: *
Gender: * Date of Birth: *
In the Space Provided, Feel Free to List Any Additional Information About Yourself:
 EMERGENCY CONTACT INFORMATION
First Name: * Last Name: *
Email Address: *
Home Telephone: (with country code) : *
Cell Phone: *
Relationship to Applicant: *
 PROGRAM:
City: *
Program Selection: *
Program Duration: *
Program Start Date: *
Program End Date: *
 ACCOMMODATION:
Accommodation Choice: *
Accommodation Start Date: *
Accommodation End Date: *
Do You Have Any Health Problems, Allergies or Concerns, Special Dietary Restrictions or Preferences, or Other Additional Comment, Please Elaborate:
 HOW DID YOU HEAR ABOUT US:
Method: *
Details: *
 ADDITIONAL COMMENTS:
Please include any additional information you feel we should be aware of:
We recommend you print a copy of this form for your reference.
We will contact you to confirm this information.
Please contact us at inquiry@globalchinaconnection.com with any questions or problems.
 APPLICANT SIGNATURE:

I declare that: 

  1. The above information provided and documents given in support of my application are complete, true, and correct.
  2. 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.
  3. I have read and accept GCC's Terms and Conditions for program participants.
  4. 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:                     
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