Application Form To apply for CLI’s Immersion Program, Study Abroad, or Teach in China program, please complete the below application form. All starred fields are required. Accepted students will receive an email with enrollment steps within three days of submitting this form. We look forward to hopefully welcoming you to Guilin soon! Basic Information *First Name *Last Name *Date of Birth (enter as Month/Day/Year; e.g. 05/16/1986 for May 16, 1986) *Gender MaleFemale *Nationality Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Holy See Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Morocco Mozambique Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Venezuela Vietnam Yemen Zambia Zimbabwe Contact Information *Email Phone (optional; only items with * required) Academic Information *Academic Standing Not Applicable High School Undergraduate 1st Year Undergraduate 2nd Year Undergraduate 3rd Year Undergraduate Degree Master’s Degree PhD (highest level completed) *Most Recent Academic Institution Primary study Approx. how many simplified characters can you recognize? *Rate your current Chinese level 0 1 2 3 4 5 6 (0 is absolute beginner, 6 is highly advanced) Program Information *Program Type Immersion Program College Study Abroad (Standard) College Study Abroad (Intensive) Teach in China *Desired Term 1 week 2 weeks 3 weeks 4 weeks 5 weeks 6 weeks 7 weeks 8 weeks 9 weeks 10 weeks 3 months 4 months 5 months 6 months 7 months 8 months 9 months 10 months 11 months 1 year Spring Semester 2018 Fall Semester 2018 Spring Semester 2019 Academic Year 2018-2019 Fall Semester 2019 Spring Semester 2020 Academic Year 2019-2020 Spring Semester 2018 Summer Session 2018 Fall Semester 2018 Winter Session 2018-2019 Spring Semester 2019 Academic Year 2018-2019 Summer Session 2019 Fall Semester 2019 Winter Session 2019-2020 Spring Semester 2020 Academic Year 2019-2020 Spring 2018 Fall 2018 Spring 2019 Academic Year 2018-2019 Fall 2019 Spring 2020 Academic Year 2019-2020 *Desired Level Kindergarten Primary School Middle School High School University *Program Start Date (All coursework begins on Monday) *Housing AccommodationPrivate Room at CLI Homestay Private Apartment Apt. w/ Chinese Roommates (3br) Dorm Room (Single) Dorm Room (Double) Homestay Apt. w/ Chinese Roommates (3br) Private Apartment *CLI Meal Plan Sign me up! Decide later (Home-cooked lunch at CLI M-F, $15 per week, amount will be added to program fee) *CLI Pengyou Program Sign me up! Decide later (Please reference the Pengyou Program section for more info; link opens in new window) *How did you hear about CLI? Word of mouth Class visitor Received brochure Facebook Twitter Instagram Reddit YouTube Google search Google image ad Yahoo/Bing search Asiaoptions.org Chinese-forums.com Digmandarin.com FluentU.com GoAbroad.com Gooverseas.com HackingChinese.com Saporedicina.com Studymorechinese.com TheChairmansBao.com Online image ad Blog post News article Other Offer Code (Offers run on limited basis) Emergency Contact Information *Name *Relationship *Email Address *Country of Residence *Home Phone Number (include country code) Cell Phone Number Applicant SignatureI declare that: The above information included in my application is accurate and correct to the best of my knowledge. I agree to abide by the laws of the People’s Republic of China and agree not to engage in any illegal activities during my academic pursuits in China. I have read and I accept The Chinese Language Institute’s Terms and Conditions Electronic Signature of Applicant I agree with all declarations stated above.