ࡱ> mol RJbjbj[[8z99W tt8)<e4ikkkkkk$<E4^ii %]+U0+Z b $ t/ :  Wzn'Yx[2018QeeSfb1X Th 2018 NTHU WINTER CULTURE SCHOOL APPLICATION FORM If you have any question, please feel free to contact e-mail: dis@my.nthu.edu.tw. Thanks! / kXhBf gNUOOUL ˊoa}e-mail : dis@my.nthu.edu.tw, ! 1. Personal information/ PNnj (First Name)/ T:(Middle Name):(Last/Family Name)/Y:Full Name in Chinese /-NeY TDate of Birth/Qut^ge(CQ)Gender/'`%R%Male/7u %Female/sYNationality/ WM|Native Language(s)/kOther Languages/vQNPassport No. (For Travel Insurance)/wgq_x 2. Contact Information/oa}nje Phone/qCell Phone/Kb_jE-mail Address (Please use your main email address for notifications)/P[O{Zip Code/^@S_Mailing Address/[0W@W 3. Emergency Contact/}%`oa}N Full Name/hQ TRelationship with Applicant/ 3uˊNoOPhone/qCell phone/Kb_jE-mail Address/P[O{Declaration of Parental or Guardian s Consent/6rkbvwNv Tarff (Minors should get the permission of parents or persons in charge of legal custody.)I hereby give my consent for my son/daughter______________to join 2018 NTHU WINTER CULTURE SCHOOL. I will be my son/daughters financial sponser and take the responsibility for his/her return to native country after he/she has completed this school program. Signature of Father/Mother/Guardia____________________________ Date______________ 4. Academic Status/x[minje Currently registered university or university to attend after winter/vMR1\x[!h(b2018%fc[1\x[!h)Department/Program/1\|@bb\;eDegree currently pursued or obtained/1\%R%High School/ؚ-N %Bachelor/'Yx[ %Master/xXs %PhD/ZSXsYear of study/vMRt^} 5.N  &(02<HJZf  v x   > B yyqqeqeqhYhiOJQJo(hYhio(hYh3jOJQJo( hLo(hYh-o( hYh3jhYh3jo(h-h-5o(h-h-5 hG,o(hG,hG,o(h3jh7CmCJ(aJ(o(hCJ(aJ(o(h3jh3jCJ(aJ(o(hCCJ(aJ(o(h'@CJ(aJ(o(h3jhG,CJ(aJ(o(&(   H J $If $da$gd3j J L kd$$Ifֈc2 !t( t0644 lap<ytYL v 7kd$$If1\>t(H & <6 t0644 lap(ytY$If $Ifgd3j    4kd$$If\bt( N t0644 lap(ytY$If $$Ifa$gdY @ B l n p 4kd$$If\bt( N t0644 lap(ytY$If $$Ifa$gdYp   0 2 dbbkdT$$If0bt( t0644 lapytY$If $$Ifa$gdY   R T n p 8:JRv68:<ݺtiti\hwhwB*o(phhJo hJo B*phhJo hJo B*o(phhkhJo 5>*B*o(phhYWB*o(phhYB*o(ph hYo( hYhY hYo(hYhYh-5o(hYhB@5o(hYhB@o( h-5o(hYh-o(h-h-5o(h-hG,5o( hp5o(#2 4 F:: $$Ifa$gdYkd$$If\l(v t0644 lap(ytY xll $$Ifa$gdYkd$$If0l(  t0644 lapytY   vjj $$Ifa$gdYkdl$$If"0l(  t0644 lapytY   T n p vtthhhh $$Ifa$gdYkd$$If0l(  t0644 lapytY H<<<< $$Ifa$gdYkd$$If\PFg( ! 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English Language Proficiency /eRbj Native/*QpuAdvance Intermediate/o}YBasic/\SNone/[hQ Ng*Listening/}*Speaking/*Reading/*Writing/[ 7. Chinese Language Proficiency /-NeRbj Native/*QpuAdvance Intermediate/o}YBasic/\SNone/[hQ Ng*Listening/}*Speaking/*Reading/*Writing/[ 8.OTHERS/vQN (1)Dietary Restrictions/ߘg:In welcome party, farewell party and culture trips, we will be providing meals for all students so please list any dietary restrictions you may have (ie. vegan, vegetarian, no dairy products or others) bP(WakΏg,akgSeSKNe-NgcOx[Tޞ Yg` \ޞ gyr%RBl ˊ(Wdk;f0(Y }ߘ NTvYTbvQNBl) (2)Winter Culture School Clothing for you/QeeSfb g݈:\[? %2XL %XL %L %M %S(3)Others/vQN:If you have any other suggestion/requirement, please let us know. Thanks. Yg`O gvQN^p/Bl ˊJTwbP !!  9.Discount/bcb Group discount-2 persons and above : 50 USD /2NN NW1XNё50bcb. 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