Study abroad in China--Learn Chinese language with homestay

Learn Mandarin with homestay in China

ATTENTION: If you apply for Homestay Only, please register here.Before completing this form, please read Registration & Payment Procedure carefully and thoroughly.

Personal Information
(All information will be kept confidential. For more info see our privacy policy)

* 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
Country code	area code	prefix	suffix
cell number
Country code	area code	prefix	suffix

* Email address

* confirm email address

* Gender

* Date of birth

* Place of Birth

Passport #

* Passport valid until

* Nationality (citizenship)

Religion

* Emergency contact person

* Relationship

* Phone number
Country code	area code	prefix	suffix

Name of school or university currently attending

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

* What is your purpose to attend the Chinese language program
Please specify

Course Information

* Please indicate which course you prefer

* Please indicate which start-finish date you prefer:

*Please indicate your Chinese language level:

Please tell us about any specific course of study that you want to pursue or any special requirements that you may have:

Homestay Information
(For detailed info about our host families, see Host Family and FAQ)

* Where would you prefer to do a homestay ?
Host family near the campus Host family downtown or other part of Beijing

* Do you prefer homestay with a private bathroom for you?
yes don't mind sharing

* Do you smoke? Yes No

* Do you mind a family with a preschool-age child ? Yes No

* Do you mind a family with pets? Yes No

* Are you interested and qualified to apply for our Free Homestay Package?(Please note that these spaces are limited, and are first come, first served)
Yes No

* If a free homestay is not available, would you still be willing to join our program?
Yes No

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

Are you interested in staying in a shared apartment after initial homestay?
(this is for longer than twelve weeks applications only. Click here for details).
Yes No, I would like to stay with the host family throughout my stay.

If you selected Yes, please indicate how long you would like to stay with a family and how long in a share apartment. Please note this plan cannot be changed once the application procedure is completed.

Please indicate a few of your hobbies or special interests and preferred lifestyle. We will try to match these with a host family

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

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.