THATCHER HOUSE
CHINESE LANGUAGE PROGRAM
NATIVE SPEAKER
First Name
Last Name
Email
Local Address
Zip
Local Phone
( )
Permanent Address
Zip
Permanent Phone
( )
High School
Transfer Student
Yes
No
9-digit Student Identifier
Major
Previous University (Name and Address)
Language
Mandarin
Minor (if any)
Cantonese
Class Year
UMass Honors
Yes
No
Gender
M
F
List all appropriate language courses you have taken or are currently taking.
Course#
Course Title
Year Taken
Institution/Address
As a member of the Chinese Language Program you will be assuming academic responsibilities in addition to
your regular course load. Consequently, it is important that you be a student in good standing. Please indicate
your GPA to date: ______
Please describe other relevant education or experience (i.e. study/travel/living/working abroad, fluency in an
additional language, language spoken in home).
1.
Why do you want to be in this Language Program? What do you expect to learn?
2.
What makes you a suitable candidate for this program?
3.
List name and department of two references (i.e. your advisor, one instructor from the language
department).
Date:
Student Signature:
PLEASE RETURN COMPLETED APPLICATION (ALL 3 PAGES) TO
RESIDENTIAL ACADEMIC PROGRAMS, 101 THATCHER HOUSE, UMASS, AMHERST, MA 01003
THATCHER HOUSE
CHINESE LANGUAGE PROGRAM
Contractual Agreement
Native Speaker
I request admission to the Thatcher House CHINESE Language Program as a native speaker participant. I agree to
participate in the CHINESE Language Program for the entire academic year, September-May, and I understand that
exceptions to this year-long commitment can be made only for a study abroad semester.
I understand and agree to the following:
1)
I will enroll in the 2-credit CHINESE 285 conversation/culture course each semester, which involves
academic work appropriate for a 2-credit course as determined by the CHINESE Department.
2)
I will speak CHINESE as much as possible with other participants in the program.
3)
I will be given a room assignment based on available space on the appropriate floor for my language.
No double single rooms can be guaranteed. The Program reserves the right to fill any empty space at any
point during the year.
 Under special circumstances, my room assignment can be changed because of changing population in the
overall Language Program.

4) I will be a "good citizen" of the Thatcher community, which includes adhering to all the rules of the residence
hall. I understand that if I break residence hall rules I may be dismissed from the Program.
5)
I will be a responsible and active member of the CHINESE 285 class, which includes:
 attending all classes, on time, according to the expectations stated in the course syllabus
 preparing class assignments to meet specified deadlines
 taking an active role in the class as well as in related activities and programs outside class
6)



I will be a responsible and active member of the overall CHINESE Language Program, which includes:
being responsible and considerate as a member of the floor community and as a roommate
speaking CHINESE as much as possible with fellow participants
taking part in program-related activities as part of the community of CHINESE speakers
I agree to notify the Residential Academic Programs office, 101 Thatcher House, in writing or in person if I wish to
withdraw from the program and I understand that I will be assigned to another residence hall based on available space.
By my signature, I agree to abide by these requirements and I understand that I may be dismissed from the Thatcher
House CHINESE Language Program if I break any part of this agreement.
Name:____________________________________________________________
PLEASE PRINT CLEARLY
Student Number:___________________________________________________
Signature:_________________________________________________________Date:____________