First Name Last Name Gender Male Female

Date of Birth D /M /Y Nationality Native Language

Company Name Occupation

Present Home Address

City Country Postal Code

E-mail Mobile Phone

Telephone Fax Passport Number

Beginner Elementary Intermediate Advanced

Feneral Chinese Business Chiness Test Preparation Other

Intensive Course Combined Coures ( 20+4 20+8 20+10 ) Private Tutoring Part Time Course Other

Starting Date D /M /Y Ending Date D /M /Y

Take care of accommodation yourself Shared Apartment Hostel Service Apartment Hotel

Arrival Date D /M /Y Departure Date D /M /Y

Arrival Date D /M /Y Arrival Time Airline Flight No.

Cash Credit Card (in person) BankWire Transfer
RMB US$ EURO

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I have read and I understood the terms outlined in Mandarin House's list of tuition, conditions and cancellation policies. I have accepted Mandarin House's terms and conditeions. I affirm that i have sufficient funds to pay all tution and the cost of food, accommodations and personal expenses during my period of study at Mandarin House. I certify that the information given by me in this application form is accurate and complete.