Taiwan Visit Registration Form
Personal Information
*
Name:
Last Name:
First Name:
*
Gender:
Please select
Male
Female
Other
*
Date of Birth:
*
Nationality:
*
Passport Number:
*
Education Level:
Please select
High School
Bachelor
Master
Doctor
Current University (If Applicable):
Graduate University (If Applicable):
Contact Information
*
Dietary Preference:
Please select
Regular
Vegetarian
Fish & Vegetables
*
Address:
Street Address:
City/District:
Country/Region:
*
Email:
*
Phone Number:
*
Emergency Contact:
*
Emergency Contact Phone:
Language Proficiency
*
Chinese Language Skills
Listening:
Select
Fluent
Proficient
Intermediate
Beginner
Speaking:
Select
Fluent
Proficient
Intermediate
Beginner
Reading:
Select
Fluent
Proficient
Intermediate
Beginner
Writing:
Select
Fluent
Proficient
Intermediate
Beginner
*
English Language Skills
Listening:
Select
Fluent
Proficient
Intermediate
Beginner
Speaking:
Select
Fluent
Proficient
Intermediate
Beginner
Reading:
Select
Fluent
Proficient
Intermediate
Beginner
Writing:
Select
Fluent
Proficient
Intermediate
Beginner
*
Cultural Interests:
Please click in order of interest (1 being most interested)
History
Philosophy
Literature
Art
Music
Garden
Architecture
Tea
Food
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Special Requests:
Please specify any special requirements or additional notes
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