学之行斯坦福学分项目报名表

1、粉丝网：http:/2013 Zest Education Overseas Programs Application FormParticipantParticipant ApplicationApplication FormForm海外项目申请表海外项目申请表Note：After filling this form, please send it to applicationhedgexch.org. Please be aware that the sooner you submit your application, the sooner we can evaluate your application. 注意：请不要更改表格中的字体或格式请不要更改表格中的字体或格式，直接填写即可。完成表格的填写后， 请将表格 word 版发送至 applicationhedgexch.org，以你的姓名学校作为文档标 题（e.g.:姓名-学校名称） 。请尽快完成申请表格，我们将在你提交表格后开始审 核，越早提交意味着越早得到你的申请结果。PART Personal Information第一

2、部分第一部分 个人信息个人信息Please use Chinese to finish this part. Items with * are mandatory. 请使用中文中文填写此部分信息，带*的项目为必填。Full Name* Gender* Date of Birth * (mm-dd-yy) Email Address*IM (QQ,MSN or SKYPE) Mobile Phone*Permanent Home Phone School Name* Current Grade*Graduating Date Family Address*TOEFL IELTS CET-4 / CET-6School RankingTop 5% Top 10% Top 25% Other粉丝网：http:/PART Awards and Honors第二部分第二部分 荣誉与奖励荣誉与奖励This may include academic honors and awards, awards for extracurricular activities and sports, etc. If

3、 the space provided is inadequate, please continue in PART Additional Information. Please use Chinese to finish this part. 我们希望了解你曾经获得的荣誉与奖励，包括学术荣誉，课外活动荣誉或体育 比赛荣誉。如果空间不足，请在第五部分 补充信息中继续填写。请使用中文中文填 写此部分。Name 奖项Date (mm- yy) 获奖日期Level（International/Nati onal/Provincial/City/Scho ol） 等级（国际、全国、省 级、市级、校级）Contact Information 可以证明此奖项的有关 联系人与其联络方式PART Extracurricular Activities第三部分第三部分 课外活动课外活动This may include school activities, work experience, volunteer experience, conferences, personal hobbies and oth

4、er experience which you believe valuable. If the space provided is inadequate, please continue in PART Additional Information. Please use Chinese to finish this part. 我们希望了解你在课堂以外的经历，包括课外活动，工作或实习经历，志愿者 服务经历，会议，个人兴趣爱好以及其他你认为有意义的经历。如果空间不足， 请在第五部分 补充信息中继续填写。请使用中文中文填写此部分。粉丝网：http:/Name 活动名称Introduction (With 30 Characters) 活动简介（30字以内）Time 参加时年级Your Role 角色PART Essays第四部分第四部分 申请文章申请文章The following essay assignment is your chance to show us who you are, what shaped you as a whole person, what you cons

5、ider important in your life and what makes you so special. Read the assignment carefully and think about how you became who you are now. Please be aware that we want to see your original essays. Any forms of plagiarism will result in the direct rejection to your application. 以下申请文章是你向我们展示你是谁的最好机会，希望你能在有限的空间 中让我们看到立体的你是什么让你成为了现在优秀卓越的你，在你的价值 观中什么是最重要的，什么让你与众不同等等。仔细阅读题目要求，认真思考 并完成文章。粉丝网：http:/特别注意：请注意申请文章的原创性原创性，一旦发现任何形式的抄袭，你将被一旦发现任何形式的抄袭，你将被 直接取消参加资格。直接取消参加资格。Personal StatementPlease briefly elabo

6、rate on one of your extracurricular activities or work experiences in the space below (150 words maximum).粉丝网：http:/Part V Additional Information第五部分第五部分 补充信息补充信息Any additional Information you would like to include in your application can be stated here. This part is not required to fill in. 其他任何你希望提供的补充信息可以在这里填写，此部分非必填写项目。粉丝网：http:/PART VI Terms of Agreement第六部分第六部分 相关条款相关条款After reading the following statements, please sign your name and dates at the bottom of this application. 在阅读以下相关条款后，请于相应

7、位置签名（电脑输入姓名即可）以及填写日 期。I certify that all information submitted in the admission process-including the application, the personal essay, any supplements, and any other supporting materials- is my own work, factually true, and honestly presented, and that these documents will become the property of Zest Education and will not be returned to me. I understand that I may be subject to a range of possible disciplinary actions, including application revocation or expulsion should the information I have certified be false.Signature: Date:

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