International University Beijing APPLICATION FORM

INTERNATIONAL UNIVERSITY BEIJING

Personal Information
First Name *
Middle Name
Last Name *
Chinese Name (if any)
Age *
Gender *
Date of Birth *
Place of Birth *
Citizenship *
Passport No. *
Place or Issue *
Date or Expiry *
SSS no. (for US only)
E-mail: *
Phone: *
Address: *
City: *
State:
Zip code: *
Country: *
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LANGUAGE Proficiency
English *
Chinese *
Others
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Current Academic Standing
Educational Level *
School Name *
Address *
Country *
Telephone No. *

In Case of Emergency
Contact Person *
Relationship *
Address *
Country *
E-mail *
Telephone No. *
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Write a PERSONAL ESSAY describing your goals for studying in China
Attached your file here
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WAIVER
I have read the website and understand the requirements for the courses at IUBeijing. *	Yes No
I promise to abide by the laws of China, and the rules of the University where the IUBeijing courses are taught. *	Yes No
I understand that the use of illicit drugs is a felony in China, and requires immediate expulsion, without refund of tuition or other fees. *	Yes No
I have purchased health insurance valid for all medical needs while in China, including return to my home country in case of emergency. *	Yes No
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By submitting this form online, I certify that the answers I have given to all questions on this application are correct and complete to the best of my knowledge. I understand that falsification or omission of information or credentials may result in revocation of admission. I also understand that I must provide official transcripts from ALL educational institutions I have attended to complete the admissions process. I further give permission for school(s) and/or college(s) to release to the International University Beijing any record necessary for the evaluation of my application for admission as requested by IUB staff/faculty.
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