Registration Form 1
Full Name:
Gender:
Male
Female
Nationality:
Native language:
Other languages you can speak:
Current living Address:
Local telephone:
Cell phone:
Fax:
E-mail:
Birth date :
year
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
month
1
2
3
4
5
6
7
8
9
10
11
12
day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Passport number:
What will your visa status in China be :
F(business)
C(Crew)
J-2(Correspondent)
G(Transit)
L(Visiting relatives)
L(Sight seeing)
L(Other private reasons)
L(Other private reasons)
Emergency contact person :
his/her phone number:
his/her e-mail:
Are there any foods you do not eat?
please describe :
Do you have any allergies (food, pollen, drugs)
please describe :
Do you have a medical condition that may effect your health or that of your host while you are living in a homestay placement?
please describe :