Fert

National Taipei University of Technology

Application for Admission for International Students Please complete this form in CAPITAL letters with a black pen. pen. March, 2011 Send two copies of this form to us before the end of March, 2011 PERSONAL A. PERSONAL DATA English Name Chinese Name (if available) Passport No. Nationality Date of birth

(date /month/year) (Given Name) (Given Name)

Please affix a recent photo here

(about 1”x2”)

English Name Chinese Name (if available) Gender Place of birth E-mail Cell Phone

(Surname) (Surname)

□ Male □ Female

Phone Mailing Address (including the postcode) Father’s Name Mother’s Name Emergency Contact Person Contact Person’s Address B. Intended Field of Study Department/ Graduate Institute Degree C. Educational History Applicant’s Education High School University/College Graduate Institute

To: From: To: From: To:

Father’s Nationality & Place of Birth Mother’s Nationality & Place of Birth Relationship with applicant Phone

Section □Bachelor □Master □Doctorate

Date Attended

From:

Name of School

Y

City and Country

Major

Degree

Date Degree Granted

M M M M M M Y Y Y

Y Y

Please attach your CV to provide additional information about your employment history and past publications.

D. Chinese and English Proficiency Mother tongue How many years have you formally studied Chinese? Where did you study Chinese? Please evaluate your Chinese language skills language Listening □Excellent □Good □Fair □Poor □None Speaking □Excellent □Good □Fair □Poor □None Reading □Excellent □Good □Fair □Poor □None Writing □Excellent □Good □Fair □Poor □None What is the name of the test? Have you taken any Chinese □ Yes Proficiency test? □ No Score/Level Please evaluate your English language skills Listening □Excellent □Good □Fair □Poor □None Speaking □Excellent □Good □Fair □Poor □None Reading □Excellent □Good □Fair □Poor □None Writing □Excellent □Good □Fair □Poor □None Have you taken any English What is the...