Professional Documents
Culture Documents
2017
2017
APPLICATION FORM FOR A TAIWAN SCHOLARSHIP
INSTRUCTIONS:
This application form should be typed and completed by the applicant. Each question
must be answered clearly and completely. Detailed answers are required in order to
make the most appropriate arrangements. If necessary, additional pages of the same
size may be attached.
Please check.
Which type of scholarship are you applying for?
Undergraduate Scholarship
Master Scholarship
Doctoral Scholarship
1. PERSONAL DATA
Chinese Name
Nationality : Nationality :
Place of Birth : Place of Birth :
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TETO in Indonesia
INFORMATION
Mailing Address (If different from above)
Telephone E-mail
Cell phone :
f. SEX
Male Female
g. MARITAL STATUS
Single Married
h. DATE of BIRTH (Day Month Year ):
i. PAST RESIDENCE in
Never ; Yes, from (dd/mm/yr) to (dd/mm/yr).
TAIWAN reason for residence :
l. HEALTH CONDITION
Excellent Good Fair
m. CHRONIC DISEASES
None
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TETO in Indonesia
Telephone : E-mail :
Cell phone :
2. LANGUAGE PROFICIENCY
LANGUAGE READING WRITING SPEAKING
COMPREHENSION
PROFICIENCY
Excellent Good Fair Excellent Good Fair Excellent Good Fair Excellent Good Fair
CHINESE
ENGLISH
3. EDUCATIONAL BACKGROUND
Level Name of Institution Country &City Period of Enrollment
Secondary
Education
Undergraduate Level
Education
Graduate Level
Education
4. REFERENCES ()
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TETO in Indonesia
6. PRESENT EMPLOYMENT
a. COMPANY/
ORGANIZATION
c. From
b. POSITION
Address
d. CONTACT
INFORMATION
Telephone Handphone :
Fax E-mail
e. TYPE OF
Govt. Ministry/ University/ Govt./State-owned
ORGANIZATION
Agency Institution Enterprise
Enterprise Enterprise
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TETO in Indonesia
f. PRESENT
DUTIES &
YEARS OF
EMPLOYMENT
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TETO in Indonesia
I am not currently undertaking studies in Taiwan for the same educational level as the scholarship type for
which I am applying;
I am not applying for this scholarship as an exchange student resulting from an agreement signed between
my home institution and any Taiwan university/college;
The information I have given on this application is complete and accurate to the best of my knowledge.
10.CHECK LIST
Two letters of reference signed and sealed en envelopes. Photo copies and email
submissions of letters of recommendation will not be considered.
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TETO in Indonesia
Applicants Signature
Date
_____ /_____/_____
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