INTER-UNIVERSITY PROGRAM FOR CHINESE LANGUAGE STUDIES APPLICATION
Using Adobe Acrobat Reader or Pro, please fill out the fields, save the document
with your name in the title, and email to iup-admissions@berkeley.edu.
Program(s) Applying For:
□ Academic Year ________
□ Summer ________
□ Fall Semester ________
□ Spring Semester ________
PERSONAL INFORMATION
(Please type or print)
______________________________________________________________________________________________________________________
Last Name
First Name
Name in Chinese Characters
Sex (Male or Female)
______________________________________________________________________________________________________________________
Present Mailing Address
Country/Zip Code or Mailing Code
Date Present Address Expires
______________________________________________________________________________________________________________________
Present Phone & Fax
E-mail Address
______________________________________________________________________________________________________________________
Permanent Mailing Address
Country/Zip Code or Mailing Code
Permanent Phone & Fax
______________________________________________________________________________________________________________________
Date of Birth
Place of Birth
Citizenship
Social Security #
Passport#
How do you rate your health at this particular time?
Excellent
□
Good
□
Fair
□
Poor
□
OPTIONAL IUP FINANCIAL AID SECTION: FOR ACADEMIC YEAR AND SEMESTER APPLICANTS ONLY
List any scholarships, fellowships, or grants for which you have or will apply this year (Fulbright, Blakemore, FLAS, etc.):
______________________________________________________________________________________________________________________
List any scholarships, fellowships, or grants you have received in the past:
______________________________________________________________________________________________________________________
List any scholarships, fellowships, or grants which you have received this year:
______________________________________________________________________________________________________________________
ANTICIPATED SOURCES OF INCOME
Family/Personal Income/Savings/Other__________________________________Scholarships/Grants_____________________________________
Loans contemplated for this year (not considered an asset when determining need) ___________________________________________________
LIABILITIES
Debt________________________________ Educational Loans_____________________________ Other_________________________________
NOTES:
1.
2.
3.
4.
5.
6.
7.
8.
All Academic Year and Semester applicants may apply for IUP tuition reductions, and all applications are judged by the same criteria.
IUP tuition reductions are awarded after admissions decisions, but if the applicant receives full or partial scholarship/funding from an
outside organization, the IUP tuition reduction will be withdrawn or reduced, based on the amount of the non-IUP award.
IUP tuition reductions are supplementary, and some students may not receive aid from IUP.
IUP tuition reduction awards are based on a combination of merit and need, but not on merit or need alone.
Due to the rigor of the program, IUP highly discourages students from working while attending IUP.
Program fees are US $17,000 (tuition and emergency medical insurance) for the Academic Year, payable in two installments, each one
due approximately two weeks prior to the start of each semester. Semester (Fall or Spring) attendance fees are US $9,000; US $5,000 for
Summer.
Other expenses not included in the attendance fees are airfare, housing, personal allowance for food, books, local transportation, etc.
Please visit http://ieas.berkeley.edu/iup/fees/html for a more comprehensive list of potential expenses not included in the program fees.
Page 2/5
ACADEMIC INFORMATION
Current Status:
□ Freshman/Sophomore/Junior
□ Senior
□Graduate Student
Degree Expected (Date)_______________
□ Professional or Employed or Other
______________________________________________________________________________________________________________________
College or University Presently Attending (degree programs only, please) Major Department
Address of Major Department
Major Advisor_______________________Thesis Topic or Research Area (if pursuing an advanced degree)________________________________
Colleges or Universities Attended:
____________________________________________from___________________to________________Degree____________________________
____________________________________________from___________________to________________Degree____________________________
____________________________________________from___________________to________________Degree____________________________
For any period not covered above (except summer vacations) what was/is your occupation?_____________________________________________
Please list Chinese language courses completed: first, spoken Chinese; second, modern written Chinese, and third, literary (classical) Chinese:
Name of Course
Number of Sem/Qtrs
Credits
Where
When
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
Length of stay, date, and purpose for previous residence in Chinese speaking areas:
PRC____________________________________Taiwan________________________________Other____________________________________
Language background and competence in other languages_______________________________________________________________________
□ IUP info session □ My instructor, name/school:___________________________________________________
□ IUP website □ Advertisement □ Poster □ Other___________________________________________________
How did you hear about IUP?
□ IUP alumnus
References have been requested from:
1.______________________________________ 2.____________________________________ 3.______________________________________
The Family Educational Rights and Privacy Act of 1974 and its amendments guarantee students access to educational records concerning them. Students are also
permitted to waive their right of access to recommendations. Do you waive your right to inspect the contents of all recommendations? Yes □ No □. If “no,”
list the recommendations that you do not waive your right to inspect:________________________________________________________________________
I certify that the above information is complete and true to my knowledge; any false statements will disqualify me for admission to IUP.
Applicant’s Signature:
To reserve space at IUP, we require a non-refundable deposit after the applicant passes the language interview (please read “Interview Requirement for All Admitted
Applicants” in the Instructions located in the Admissions section of IUP’s website). IUP expects applicants to know their general financial situations (whether or not
they can afford to attend IUP) BEFORE IUP invites applicants to pay their non-refundable deposits.
I understand IUP’s policy on non-refundable deposits, and I understand that it’s my responsibility to know my financial situation for attendance at IUP.
Applicant’s Signature:
Your application is incomplete without references and transcripts. Please make sure all requirements from the “Application Instructions” are emailed
to: iup-admissions@berkeley.edu.
Page 3/5
STATEMENT OF PURPOSE
Please use this sheet (or your own separate sheet) for a Statement of Purpose (500 words or less). Please type your e-mail address at the end of
your statement if you didn’t do so on the Personal Information page.
Applicant’s Signature
Page 4/5
INTER-UNIVERSITY PROGRAM FOR CHINESE LANGUAGE STUDIES
Reference
□
Fall Semester Program□
Spring Semester Program□
AND/OR Summer Intensive Program□
Name of Applicant_____________________________________________________________for admission to the Academic Year Program
NOTE: THIS FORM SERVES AS A GUIDELINE FOR REFERENCES; SENDING/INCLUDING THIS FORM TO IUP BERKELEY IS OPTIONAL.
Referee________________________________________________________ Title____________________________________________________
Institution______________________________________________________________________________________________________________
How well, how long, and under what conditions have you known the applicant?_______________________________________________________
What is your role in relation to the applicant?__________________________________________________________________________________
The Committee on Admissions and Awards is particularly concerned with the candidate’s future potential and promise in his/her chosen field; his/her
emotional stability; evidence of drive and motivation; character and sense of responsibility; and whether or not you feel this is an appropriate time in
the student’s academic career for advanced intensive language study in Beijing.
Signature_______________________________________________________________ Date___________________________________________
INSTRUCTIONS: Use this form as a guide when writing your reference letter.
 If you forget to include this form with your letter, IUP will still accept your letter without this form.
 Please email your letter as a Word or PDF document to iup-admissions@berkeley.edu. Please write applicant's name and term & year
applying for in subject line (e.g. Recommendation for Jane Chang, Summer 2015 program).
 We recommend sending Summer & Spring recommendation letters immediately due to our rolling admissions policy for those programs.
Page 5/5
INTER-UNIVERSITY PROGRAM FOR CHINESE LANGUAGE STUDIES
Reference
□
Fall Semester Program□
Spring Semester Program□
AND/OR Summer Intensive Program□
Name of Applicant_____________________________________________________________for admission to the Academic Year Program
NOTE: THIS FORM SERVES AS A GUIDELINE FOR REFERENCES; SENDING/INCLUDING THIS FORM TO IUP BERKELEY IS OPTIONAL.
Referee________________________________________________________ Title____________________________________________________
Institution______________________________________________________________________________________________________________
How well, how long, and under what conditions have you known the applicant?_______________________________________________________
What is your role in relation to the applicant?__________________________________________________________________________________
The Committee on Admissions and Awards is particularly concerned with the candidate’s future potential and promise in his/her chosen field; his/her
emotional stability; evidence of drive and motivation; character and sense of responsibility; and whether or not you feel this is an appropriate time in
the student’s academic career for advanced intensive language study in Beijing.
Signature_______________________________________________________________ Date___________________________________________
INSTRUCTIONS: Use this form as a guide when writing your reference letter.
 If you forget to include this form with your letter, IUP will still accept your letter without this form.
 Please email your letter as a Word or PDF document to iup-admissions@berkeley.edu. Please write applicant's name and term & year
applying for in subject line (e.g. Recommendation for Jane Chang, Summer 2015 program).
 We recommend sending Summer & Spring recommendation letters immediately due to our rolling admissions policy for those programs.