Hanban-CollegeBoardChineseGuestTeacherProgramApplicationFormforChineseTeachersLastNameFirstNameEnglishNameGenderMaleFemale(Ifany)PlaceofBirthDateofBirthPHOTOMaritalStatusSingleMarriedDivorcedEnglishProficiencyOtherLanguage(s)HighestDegreeBachelorMasterDoctorMajorObtainedGraduatedFromGraduationYearElementarySchoolteacherJuniorMiddleSchoolteacherCurrentPositionSeniorMiddleSchoolTeacherCollegeteacherTeacherinotherschool,pleasespecifyOtherPosition,pleasespecifyMandarinLevel1A(Highest)1B(Higher)2A(High)NoneDateObtained:CertificateofTeacherType:College/UniversitySecondarySchoolPrimarySchoolQualificationVocationalSchoolOtherSchoolNoneType:CollegeEnglishTest(CET)TestforEnglishMajor(TEM)CertificateofEnglishTOEFLIELTSOtherNoneLevelDateObtained: Level/Score:YesNoneCertificateofTeachingChineseasDateObtained:Level:ForeignLanguageYes,expiresonDriver’sYes,obtainedon:ValidPassportNoLicenseNoSchoolNameWorkPhone:SchoolAddressPostalCode:DoesyourcurrentschoolhaveasisterYes,TheU.S.sisterschool’sname,cityandstate.schoolrelationshipNowithanyU.S.schools?HomeAddressPostalCode:HomePhoneCellPhone:EmailAddressFaxNumber:EmergencyContactName: Phonenumber:PersonRelationship: Address:HaveyoueverbeenoutsideofChina?YesIfyes,whenandwhere?NoFamilyBackgroundRelationshipNameProfessionPlaceofworkCityProvincePhone#SpouseChildFatherMotherBrother(s)Sister(s)Doyouhaveanyfamilymembersand/orrelativesintheUnitedStates?Yes.Ifyes,explainyourrelationtotheperson(s)andtheirimmigrationstatus:No.EducationBackground(sincehighschool)WorkExperienceAwardsReceivedPleasedescribewhyyouwanttobeaChineseguestteacherintheUnitedStates(Maximum600words)EmployerPermission(withstamp)ProvincialEducationDepartmentPermission(withstamp)Bysigningthisform,Icertifythatallinformationprovidedaboveistrueandcompletetothebestofmyknowledge.Iunderstandthatifanyofthisinformationisfoundtobesubstantiallyinaccurateorincomplete,myapplicationtothisprogramwillnotbeconsidered.Signature:_________________________Date:______________________NOTE:1.Fillinallblankswithtrueinformation;2.Attachextrapagesifnecessary.