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National Taichung University of Science and Technology

Application Form for Admission of International Students

TO THE APPLICANT

This application form should be completed with two copies.

Please complete this form in Chinese or English and print in LOC! LETTE"#.

I. Personal Information

Applicant$s
Name
%Chinese& %English&

'ate of irth
(dd/mm/yy)

(ender
)ale *emale

Nationalit+

irth Place
!"#$
Passport No.
% &
Home Address
'(&
)ailing
Address
)*+,E,
mail
) -
Telephone
% &
./)-
Cell phone
0123
)arital status
40)arried 50#ingle
67Other
*
No. of
Children
9:;
Applicant$s
*ather

Chinese
Name

English
Name

'ate of irth
(dd/mm/yy
)

Nationalit+
9<;
Applicant$s
)other

Chinese
Name

English
Name

'ate of irth
(dd/mm/yy
)

Nationalit+
=>?@
Contact Person
in Taiwan

Chinese
Name

English
Name
) -
Telephone
)*+,
E,mail
-
Application Form 1/
!"#$%
Attach a recent
photograph here
&about
-./0.'
=>?@
%&
Address of
Contact Person
in Taiwan
0
. ()*+!ducational "ac#ground
,
$egree
-.
Secondary school
/
%ollege or University
012
&raduate school
'(aster Program)
ABC
Name of school
ABD=
Address
AE
'egree granted
FG
)onth1+ear of
(raduate
HI
)a2or
JI
)inor
3. 456789:;
Please specify department 'graduate school) and degree of application at NT%UST.
K D
'epartment
%(raduate #chool&
AE
'egree
AL%MN& achelor %four +ears&
AL%ON& achelor %two +ears&
PL)aster
.<=.>?@ABC
*our ma+or source of financial support during your study at NT%UST
QRSPersonal #a3ings TUAmount
:<VW Parental support TUAmount
>X YZ D Taiwan *ellowship
YZ D #cholarship [\#ource TUAmount
67[\Other #ource
. DE Scholarship
]^_B`A AZa D Are +ou appl+ing for NTC4#T$s International #tudent #cholarship5
]6es ^No
7
Application Form ,/
.FG$ormitory
]^bc_BAdeaAre +ou appl+ing for dormitor+5
]fghc%deg ijkdelm H
6es. I would li8e to li3e in the dormitor+ and will compl+ with all regulations.
nghnbcde
No. I am not appl+ing for a dormitor+.
. IJK-anguages A.ility
English Language
]^opqrr L
stuv5
Ha3e +ou ta8en an+
English proficienc+ test5
]6es

^ No
wxuv
If +es9 list the
proficienc+ tests
yz
#core
{h|MPlease e3aluate +our English language s8ills.
}Listening ~E/cellent (ood N A3erage Poor
#pea8ing ~E/cellent (ood N A3erage Poor
"eading ~E/cellent (ood N A3erage Poor
:riting ~E/cellent (ood N A3erage Poor
Chinese Language
A5
How man+ +ears ha3e +ou formall+ studied Chinese5
A%Ar&a
:here did +ou stud+ Chinese %elementar+ school9
high school9 college9 language institute&5
]^opqrs L
tuv5
Ha3e +ou ta8en an+
Chinese proficienc+ test5
]6es

^ No
wxuv
If +es9 list the
proficienc+ tests
yz
#core
{h|MPlease e3aluate +our Chinese language s8ills.
}Listening ~E/cellent (ood N A3erage Poor
#pea8ing ~E/cellent (ood N A3erage Poor
"eading ~E/cellent (ood N A3erage Poor
:riting ~E/cellent (ood N A3erage Poor
;
Application Form //
. OP0thers
9 Q Please specif+ if +ou ha3e an+ ph+sical illness or disabilit+.

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If +ou ha3e an+ publication= please list b+ published +ear9 title of publication9 publisher9 and location.
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:or8 e/perience.
)onth16ear

*ull1Part Time

Name of Organi>ation
C
Position Held
E
?
Application Form /