Customize Your Study

Register Online
Attention: Before completing this form, please read Registration & Payment Procedure carefully and thoroughly.


Course Information

* Please indicate which program you prefer:    

* Please indicate which start-finish date you prefer:   -                 

* Please indicate your Chinese language level:

* How long have you been studying Chinese?  

* How many Chinese characters you can recognize?  

Please describe specific course requirements or fields of interest within your program:


What are your expectations or goals you hope to achieve through this program?


What do you want to do most while you stay with Lotus? Why?

Personal Information


* First name       * Last name  

* Street Address     * City  

State in the U.S. State or region outside of the U.S.

* Country     Zip code

* Phone number     Cell number

* Email address    * Gender  

* Date of birth           * Place of Birth  

* Passport #   * Passport valid until        

* Nationality (citizenship)  

* Emergency contact person   * Relationship  

* Emergency contact number  

Please indicate your major and graduated university

Employment History:(Job Title, Employer, Dates of Employment, etc.)


Name of medical insurance carrier:

Policy number:

Homestay Information

* Do you mind sharing the bathroom with your host family?
* Do you smoke?  

* Do you mind a family with a preschool-age child ? 

* Do you mind a family with pets? 

Please list any allergies, health problems, or foods that you can not eat:


Please indicate a few of your hobbies or special interests:


Please indicate your personality and lifestyle:


What do you expect from your host family?


What sort of family personalities suit you best?


Use the space provided below for any additional detail about yourself.


How did you hear about Lotus? Please specify:

TERMS AND CONDITIONS

By initialing below,I agree that I have read the program information, understand and accept the conditions under which these programs will be conducted, particularly those which apply to the program cost, and refund policy. I understand that the program cost includes administrative expenses, and hereby release Lotus, their agents, employees or representatives from all actions suits, claims, or liability for damages arising out of my participation in the program. I confirm that I have also read the "Notice of Understanding Between Participant and Lotus"
* Please type initial here  

Type Verify Code:  

Before submitting the registration form, please print it out for your record. If you can't make on-line submission, please fax the printed form to us at 408-884-2429 or download the registration form, fill it out and send it to reg@lotuseducation.org.

 

 


 
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