Application Form

Huayu Enrichment Scholarship（ HES） of Taiwan（ 2009）

1. PERSONAL DATA
Surname（Last name）： Please attach a color

Given Name(s) ： photograph that has been

NAME
taken within the last 3
Chinese Name（optional）：
months.

PLACE OF BIRTH

NATIONALITY
*Note: If one or both of your parents were an ROC national at the time of your
birth, you are an ROC national as well and therefore not eligible to apply.

CONTACT Permanent Address：

INFORMATION Mailing Address (If different from above)：

※ Will be used to Telephone/ Mobile：

inform the result of

E-mail：
the HES selection！

GENDER □ Male　 □ Female

MARITAL STATUS
□ Single □ Married
DATE OF BIRTH (Day／Month ／Year ):

HEALTH CONDITION
□ Good □ May need special assistances in _____________________
□ Chronic Diseases (Please specify)__________________________________
Name: Relationship:
EMERGENCY
Address:
CONTACT PERSON
Tel: E-mail :

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2. LANGUAGE PROFICIENCY

LANGUAGE COMPREHENSION READING WRITING SPEAKING

PROFICIENCY
Excellent Basic Excellent Basic Excellent Basic Excellent Basic

CHINESE

ENGLISH
OTHER
Please state：

3. EDUCATIONAL BACKGROUND
Period of
Level Name of Institution and Department Country/City
Enrollment

Undergraduate Level
Education

Graduate Level
Education

4. REFERENCES （Fill the list if you have one and attach their reference letter ）

Name Position Contact information : Phone, E-Mail, etc.

5. PREVIOUS EMPLOYMENT (Use one line for each position)

Position Company/Organization Period of Employment Responsibilities

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 6. PRESENT EMPLOYMENT

COMPANY/

ORGANIZATION

POSITION

Address：
CONTACT INFO. Tel ：
E-mail：

TYPE OF
□ Govt. Ministry/ Agency □ University/ Institution □ Govt./State-
owned Enterprise □ Locally-owned Enterprise □ Joint Venture □ Foreign-owned
ORGANIZATION
Enterprise □ NGO

7. LANGUAGE CENTER WHICH YOU PLAN TO ATTEND IN TAIWAN

Name of the chosen University affiliated language centers:
(Example: 1. Mandarin Training Center of National Taiwan Normal University 2. International Chinese Language
Program of National Taiwan University )
1.
2.
3.

Note ：Every applicant shall choose at least one Language Center. For information about
university-affiliated language centers in Taiwan, please visit the official website at:
http://english.moe.gov.tw/ (Home> Study in Taiwan> Chinese Language Center)

8. PLEASE STATE YOUR STUDY PLAN WHILE IN TAIWAN

（Type in one A4 paper and attach it into this form）

9. DECLARATION:
I declare the information I have given on this application is complete and accurate to the best of
my knowledge.

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Signature ： Date ：

※ Contact us：
Cultural Division, Taipei Mission in Sweden
Wenner Gren Center 18tr. Sveavägen 166, SE113 46, Stockholm
Tel: +46-08-328200 Fax: +46-08-328240
Email: culture@tmis.se