Application Form: Full Immersion Chinese Camp/Volunteering in China
July 05 - 24, Taizhou, China
Email address *
Full Name *
Gender *
Date of Birth *
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First Language
Second Language
Primary Phone *
Secondary Phone
Home Mailing Address *
School Attended (If you are a student)
Name of Primary Parent (If you are under 18 yrs old) and his/her phone number
Emergency Contact 1 *
Emergency Contact 2
Do you have any teaching experience? If yes, please briefly tell us about your experience. (Teaching experience is not required.) *
Do you have any teaching certification? If yes, what is it? *
Have you learnt Chinese? *
How do you learn Chinese?
How long have you been learning Chinese?
Chinese Language Proficiency
Clear selection
Have you been to China before? *
If you answered yes to the last question, how long did you stay in China last time?
Are you currently receiving medical treatment? *
If you answered yes to last question, please explain
Are you allergic to any food or medicine? *
Do you have any type of special diet that we should know about for medical or religious reasons? *
Your Insurance Carrier
Insurance I.D. #
How many children will you bring? (If you are a parent, we cover expense of one dependent per parent. The cost of any extra dependent is $700 per person )
Clear selection
Full Immersion Chinese Camp *
Full Immersion Chinese Camp for Your Child(ren) (If you bring any with you) *
How many weeks would you like to volunteer in our program?
Clear selection
Do you have any other question or request?
Declaration of Applicant: *
Required
Electronic Signature of Applicant *
Date of Today *
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How do you know about our program? *
If you have any question, feel free to call 737-247-1533, or email: intensive.mandarin.class@gmail.com
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