Name
Faculty
Date of Birth
Email Address
Address
Email
Program
Student Number
Gender: Male Female Current Year of Study
Phone
Are you a Canadian citizen?
Yes No
Do you have a valid Canadian
Passport?
Yes No
Passport Expiration
Please provide us with an emergency contact we can reach during your China Study Tour experience.
Name:
Relationship:
Address:
Primary phone:
Do you have any special dietary needs?
None
(circle your selection)
Vegetarian Vegan
Other (please specify):
Do you have any allergies? Yes No Please specify:
Halal Kosher
Language ability: Please specify your English proficiency. (circle your selection)
None Basic Functional Advanced Native
How did you hear about this opportunity (website, friends, other)? ________________________________________________
I confirm that the information on this form is correct and will be used by the National Capital Confucius Institute in the selection of participants. If accepted into the program, I will abide by the requirements in the associated

participation waiver.
Signature Date
I authorize the National Capital Confucius Institute and the International Student Services Office to use my name, my photos and any materials produced during the experience in future program material appearing in brochures, posters, presentations, websites, etc.
Signature Date

This program is open to students at both the graduate and undergraduate level at Carleton University.
Students will be selected based primarily on their interest in pursuing Mandarin training, and on their academic and professional interest in China. It is highly recommended that you clearly outline how participation in this program will enhance your ability to achieve your goals in a cover letter to accompany the first page of this application form.
Please answer the following questions in your cover letter.
Why do you want to participate in the China Study Tour Program?
What skills and/or knowledge do you possess that will support its success?
Have you ever considered studying or working in China? If so, in what capacity? What do you think you would gain from this experience?
Please indicate specific skills or experiences you will acquire and their relevance to your program of study or career objective.
Do you have any mandarin training? Please describe briefly.
While you are on location, you may not have your usual reference points given the new environment (different culture, language, etc.); what competencies do you have or think you need to adapt effectively in a different setting? If possible, use examples of situations you have been in. Explain how you plan to deal with these cultural differences.
Application Process
Students must submit an application by email to isso@carleton.ca or in person to the International
Student
Services Office with the following:
• a cover letter
• subject heading “2016 China Study Tour”
• a recent transcript
• an updated resume
• a completed application form
• a scanned copy of a valid passport
Selections will be made based on their applications. Applicants may be invited to an interview before final selections are made for the trip.

For more information contact:
•
•
Cody Wise , 613-520-2600, ext 2069, email: cody.wise@carleton.ca
Justin Li , 613-520-2600, ext. 2019, email: JustinJ.Li@carleton.ca