Application for the 2012-2013 Globex Program
Program
PKU-UD Global Educational Exchange Program
PERSONAL INFORMATION
Name in
Chinese
Student No
ID No
Passport Name
& Nationality
Passport No
& Expiry Date
Date of Birth
Day
female
Sex
Month
male
Year
Photo
Contact Info
Cell Phone
E-mail
Home Address
EMERGENCY CONTACT PERSON
Relationship
to You
Name
Contact Info
Address
(if different from your home address
Cell Phone
E-mail
ACADEMIC INFO
Academic
Situation
English
Proficiency
Year of
Study
Major
GPA
Class Rank /
Class Size
Provide all relevant info (TOEFL, IELTS, CET-4, CET-6, etc.)
YOUR PROPOSED PROGRAM OF STUDY AT HOST UNIVERSITY
Your Choice of Department & Major at Host University
Your PKU Program Courses
Equivalent Host University Courses
Comment
1.
2.
Required
Courses
for
Coming
Semester
3.
4.
5.
6.
7.
1.
Elective
Courses
for
Coming
Semester
2.
3.
4.
5.
Instructions:
1) Complete the form in full, 2) Attach a copy of your resume, 3) Submit your all application materials to
Liu Ning (globex@coe.pku.edu.cn,
6275-6184).