Student Information Sheet
Chinese Studies Program, UCSD
Chinese: Student Info Sheet
Part One: Personal Information
Full Name *
Your answer
Chinese name (if applicable)
Your answer
P. I. D. # *
Your answer
Phone *
Your answer
E-mail *
Your answer
College *
Required
Anticipated graduation year *
Your answer
Major/minor *
Your answer
Part Two: Reason for Taking Chinese:
Choose all that apply *
Required
Grade option
Part Three: Exams Related to Chinese Language
If you have taken SAT II or AP Chinese Exam, please write down the exam and your score.
Your answer
Part Four: Prior Experiences
List ANY (including grade & high school) Chinese language courses you have ever taken/attended.
Course Title/ When/Textbook/Where/Course Grade
Your answer
Part Five: Background Information
1. Were you born in the United States? *
If NO, at what age did you come to the United States?
Your answer
2. Have you lived in a Chinese speaking country/area (such as China, HK, Taiwan, Macau, Singapore, etc.)? *
If YES, when and where?
Your answer
3. What language(s) or dialects do you speak with parents/siblings/relatives? *
Your answer
Acknowledgment
** By signing below the student hereby certifies that all above information is true and understand that withholding or false reporting of information may result in not receiving credit(s) for course work and/or disciplinary action(s). **
Signature *
Your answer
Date *
MM
/
DD
/
YYYY
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