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1、 Language and Culture Camp application formXxxxxxxx Language and Culture Camp Application Form Personal Information 1. Given name: xxxx Surname: xxx 2. Nationality: xxxx 3. Passport no: xxxxx 4. Sex: Male Female 5. Date of birth (dd/mm/yy): xxxx 6. Mailing address: xxxxxxxxxx, China 7. Email: xxxxxx
2、xxxxxxx 8. Telephone number (Home): Mobile number or contact number: xxxxxxxxxxxxxx Emergency Contact Name: xxxxxxxx Relationship: xxxxxxx Telephone: xxxxxxxxxx Address: xxxxxxxxxxx Education 1.Name of your Institution : 2. Field of Study: Language proficiency Please indicate your proficiency: Excel
3、lent, Good, Fair, Poor. Reading Writing Listening Speaking English Thai language background Have you ever studied French before? Yes No If yes, When. How long Where. Signature of applicant: Date: Please submit this application with your passport copy via email or fax by July 15th. Thank you. Email: xxxxx Fax: xxxxxxx
