Registration Form First Name Last Name



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National Chiao Tung University

2013 Summer Program Registration Form


First Name




Last Name




Photo


Nationality




Gender




Birth Date

YYYY/MM/DD

Passport No.




School Name




Major(s)




Undergraduate

  • Freshman □ Sophomore □ Junior □ Senior

Phone No.




Email




Mailing Address



Partner University Student

  • Yes □ No


Modules

NCTU has four Modules. Student should select at least one of them.

  1. Basic Professional Courses

□ Skip

Course Name




Mobile Device Programming

□ Join

Wonders of the Mathematical, Physical and Chemical Worlds

□ Join

  1. Mandarin Course

  • Join □ Skip

  1. Management Course

□ Skip

Course Name




Emerging Competitiveness

(Lecture in Mandarin)



  • Join

Emerging Competitiveness

(Lecture in English)



□ Join

  1. Culture Courses

□ Skip




Course Name







Experience Taiwan, Taiwan Experience

□ Join




New Media and Design in Architecture

□ Join

Mandarin Learning Experience

How long have you learned?

□ Never □ Less than a year

□ More than a year



Accommodation

(4 students share 1 room)

  • Yes □ No

If you have special needs, please describe:_____

________________________________________



Special Health Condition

  • Yes □ No

Fees

The miscellaneous fee NTD 8,000 is mandatory. The total fee for the 2013 Summer Program is based upon the selected Modules, Accommodation and Miscellaneous. Please fill out the amount. NCTU will help you to check the total payment.

Modules

Fee

Partner University

Non Partner University

Basic Professional Courses

NTD 3,200

NTD 3,200

(If you select this module, please fill out NTD 9,600)

Mandarin Course

NTD 3,200

NTD 3,200

(If you select this module, please fill out NTD 9,600)

Management Course

NTD 3,200

NTD 3,200

(If you select this module, please fill out NTD 9,600)

Culture Courses

NTD 3,200

NTD 3,200

(If you select this module, please fill out NTD 9,600)

Accommodation

NTD 6,000

(If you need the accommodation, please fill out NTD 6,000)

(If you need the accommodation, please fill out NTD 6,000)

Miscellaneous

NTD 8,000

NTD 8,000

NTD 8,000

1 Module Total

NTD 17,200

Please fill out the total

Please fill out the total

2 Modules Total

NTD 20,400

Please fill out the total

Please fill out the total

Note: Please attach your scanned student ID card when you email the application form.
A confirmation letter will be issued within one week, once NCTU receives your application. The whole registration process will be completed, after received the payment. You are welcome to contact coordinator Ms. Avis Liu either by email: avisliu@nctu.edu.tw or by phone: +886-3-571-2121 Ext. 50661 for further assistance.
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