J-1交换生英文申请表(2012-2013).docx

2012-2013 AYPPage 01 - Students InformationPhotoSmilingStudents NameFamily Name（姓） First Name（名） LAI BOQIAO Program InformationProgram Additional Programs 12/13AYP International Representative Complete Mailing AddressStreet Address City of Birth#406,building NO.12,Suzhouyard,Jinan university,Tianhe district Guangzhou City Country of BirthGuangzhou China Zip Code Country Country of Citizenship610632 China China Telephone No. Fax No. Country of Legal Permanent Residence+8602085226299 China E-Mail Religious A No Sex Date of Birth (mm/dd/yyyy) Passport Number (if known) 09/26/1995 G30498100 Male Female I.D. No.:FAMILY INFORMATIONFathers Name Mothers NameLai Buzhong Xiao Xiuling Address Address#406,building NO.12,Suzhouyard,Jinan university,Tianhe district,Guangzhou #406,building NO.12,Suzhouyard,Jinan university,Tianhe district Country CountryChina China Year of Birth (yyyy) Speaks English Year of Birth (yyyy ) Speaks English1962 Yes No 1963 Yes NoBusiness Phone Employed By Business Phone Employed By+8613503049993 UNION INSURANCE BORKER CO.,LTD +8613544445046 Jinan university Occupation Occupationmanager clerk EMERGENCY CONTACTName Xiao Xiuling Phone Number+8613544445046 Address#406,building NO.12,Suzhouyard,Jinan university,Tianhe district CountryChina Page 02 - SiblingsBROTHERS and/or SISTERS Name Date of Birth Sex Living at home?NONE Male FemaleYes NoNONE Male FemaleYes NoNONE Male FemaleYes NoNONE Male FemaleYes NoPage 03 - Personal DataCheck any activity in which you participate in your home country (check at least 3 and no more than 6).AerobicsAmerican footballArt/PaintingArts & CraftAttending concertsBackpacking Badminton BaseballBasketballBike RidingBowlingBoyscouts/GirlscoutsCamping Church activities Community workComputerCooking/BakingDancing Family ActivitiesField HockeyFishingFitness Training Going to the moviesGolfGymnastics Handball Hiking, BackpackingHistoryIce Hockey Ice Skating Inline Skating Listening to classical musicListening to popular musicMartial artsMuseums MusicPainting, DrawingPhotography PicnicsPlaying board gamesRacquetballRaising AnimalsReading Riding HorsesSailing/boating School activities Sewing ShoppingSnow Skiing Snow sports SoccerSurfingSwimming Table tennis Tennis TheaterTrack and Field Travel Visiting relatives VolleyballWalkingWatching sports Watching TV Water SkiingWindsurfingWoodworking Wrestling WritingOther: Please list any other specific interests, hobbies and activities and any awards or commendations:Do you Play in a band? Yes No Do you play in an orchestra? Yes No If yes, what instrument(s)? Do you participate in any competitive sports? Yes No If yes, what sport(s)? Tennis How often do you attend church? NONE Are you active in any church groups? NO Would you be willing to attend church with your host family? Yes No Do you smoke?Yes No For your information: The purchase and/or smoking of cigarettes for persons under age 18 is illegal in most parts of the USA. Individual host families may have additional rules which must be followed by the student.Are you allergic to animals?Yes No If yes, what animals? If you are allergic, is your allergy controlled by medications?Yes No Are you allergic to medications?Yes NoIf yes, what medication? How many years have you studied English?9 List the chores for which you are responsible at home.Washing dishes,sweeping the floor,Cooking Briefly give reasons for wanting to become an exchange student.The perience of exchange is veluable for me,I can boost my culture awearness and share Chinese culture with people who live in the states. Page 04 - Family Photo AlbumOn this section please upload recent photos (within 2 years) of you, your family and friends. Describe each photo on the space provided. Please feel free to upload any additional pictures.Page 05 - Student Letter of IntroductionIn your own words write a letter that will tell about your personal interests. Your letter should be typed in English. Include comments about you and your hopes and expectations for your stay. Describe how you will share your culture. Tell us about your natural family as well as your personality, hobbies and interests.Dear host family: I am a student from Guangdong experiment high school, which is a renowned school around the world in Guangzhou China. I Know I would live and study in the states for 10 month and I m looking forward to enjoying this valuable experience. Its well-known that the US is superpower and the culture and idea are extremely diverse from Chinese. In order to experience and feel that I decided to join this exchange program nothing could be nicer than the crashing and mixing of cultures. Commonly, I like playing tennis with my parents and friends; I am in the school tennis team and have achieved some awards. I learnt many things through playing tennis such as nobody could be successful without struggle and everything start from LOVE.I make many friends by tennis and I enjoy the process of taking a tennis Ace. In musical, I started to play the piano when I just a little boy and the piano become one of the most important things in my live .I can feel relax and silent while I am playing the piano. The pianoludes I like best is and . Certainly, I also keen on playing traditional Chinese pianoludes like I hope that could be a part of culture exchange. I am an adaptable boy, Nowadays, I study in a boarding school and at the beginning of the first term, many of my classmates and roommates cant accept the change of their life but I find that I can fit the new condition rapidly. Gold cant be pure and man cant be perfect, everyone has disadvantages as well as me, I am a little bit lazy in sometimes but I am trying to change it. In additionl, my father has been a national champion of shooting when he was young. At last, I am very grateful to you for accepting me and allow me to be one of your family members, Thank you for considering hosting me. Sincerely B.P.Shepherd 17/12/2011 Page 06 - Parents Letter of IntroductionPlease type a letter in English in the space below to the host parents who will share their home with your son or daughter. Describe your childs personality and interests, expectations and relationships. We ask that you be very frank and honest in your letter, and that you comment on your childs strength and weaknesses. This will be very helpful to us in finding the best host family for your child.Dear host family: Hi, I m Benjamins father; my son would stay in your family during the exchange program and live with you and your family. I am very grateful to the accepting and hosting. I hope my son can be the envoy of culture exchange and spread Chinese culture to the US. This experience is valuable and rewarding to my son. Now, let me introduce my family, our family is a small but lovely, there are three people in this family, my wife, my son and me. My wife works in a university and Im an athlete when I was young but now Im an insurance broker. My son is an active even a little bit naughty boy when he just a kid. We educate our son in a traditional way in Chinese; however, Ben doesnt deem that is a good way so he is intractable sometimes. We are trying to make him to be an outstanding person and he doesnt let us astray. We think integrated development is necessary for Bens growth and we are acting all the time. In additional, we hope Ben can learn how to be thankful during the program. Lack of gratitude is a wide problem in china in my opinion and that is a very significant part of a person. We know the aim of this program is to exchange culture and ideas. Ben acts the role of envoy and we believe he can act well.At last, I thank you again and appreciate for receiving my son. Yours Lai Buzhong 18/12/2011Page 07 - School InformationTRANSCRIPT OF GRADESThis side is to be completed and signed by the School AdministratorSchools Name Address Telephone Public or PrivatePublic PrivateAdministrators Name GRADE CONVERSION CHARTPlease explain your grading system.American Grades Country Equivalent Comments or explanationsSuperiorA+ ExcellentA Very GoodA- or B+ GoodB or B- AverageC SufficientC- PoorD FailF What grade level will student have completed upon arrival in the USA? 9th 10th 11th 12thUpon arrival, will the student have completed secondary school in his/her home country?Has the student received a diploma in his/her home country? Yes NoDoes the student need to have his/her transcript convalidated? Enrollment in the exchange program is primarily for a cultural exchange. A high school diploma or graduation is not guaranteed to any student. Credit for academic achievements earned while abroad shall be determined solely by the students native school upon the completion of the program. While the program cannot guarantee specific courses will be available for this student, please list any courses you recommend this student be enrolled in while partipating in the exchange program, especially for those who need to convalidate their grades. Administrators Name: Official School Stamp:Administrators Signature: Date: Page 08 Transcript of Grades TRANSCRIPT OF GRADES continuedIn English, type names, hours per week, and the final (American-equivalent) grade for the classes you attended in the 9th, 10th, 11th and 12th grades. Indicate the grade in which you are presently enrolled. In addition to this translation, please also attach a copy of each years transcript of grades issued by your school. School Year:(yyyy) to (yyyy)9th year classesHours per weekFinal Grade(Am.Equivalent)ChineseMathEnglishPhysicsChemistryBiologyPoliticsHistoryGeographyMusicP.E.Fine ArtsComputerSchool Year: (yyyy) to (yyyy)11thyear classesHours per weekFinal Grade(Am.Equivalent)ChineseMathEnglishPhysicsChemistryBiologyPoliticsHistoryGeographyMusicP.E.Fine ArtsComputerSchool Year: (yyyy) to (yyyy)10thyear classesHours per weekFinal Grade(Am.Equivalent)ChineseMathEnglishPhysicsChemistryBiologyPoliticsHistoryGeographyMusicP.E.Fine ArtsComputerSchool Year: (yyyy) to (yyyy)12thyear classesHours per weekFinal Grade(Am.Equivalent)ChineseMathEnglishPhysicsChemistryBiologyPoliticsHistoryGeographyMusicP.E.Fine ArtsComputerPlease attach a copy of each years transcript of gradesStudents must bring an official transcript with them for scheduling purposes in the American School.All documents must be translated into English.Page 09 - Language EvaluationPages 9 and 10 must be completed by Present English teacherThe purpose of this form is to help us evaluate this students reading, writing, and verbal English language skills. It is crucial that your evaluation be as accurate as possible. Rating a student better than his or her actual ability may result in serious problems for the student and the host school. We trust you will be conscientious during this interview and will complete our form carefully, accurately and honestly. Thank you.Reading: When asked to read aloud in English from a book, magazine, or newspaper, the student is able to:Excellent Read with few errors and can easily explain its meaning.Good Read well except for very difficult terms and can explain most of the ideas.Fair Read most of the vocabulary and explain the basic idea.Poor Read and understand only the simplest words, and can explain little or none of the meaning.Writing: When asked to write a short essay in English stating what he or she hopes to gain from being an exchange student, the student:Excellent Writes fluently using lengthy sentences and abstract terms, with a good English vocabulary and sentence structure.Good May use irregular grammar, but uses fair vocabulary in lengthy sentences.Fair Writes only simple sentences with elementary vocabulary. Grammar is extremely irregular, but understandable.Poor Uses very limited vocabulary and is difficult to understand.Verbal: Estimate the students ability to understand and speak English after engaging the student in English-only conversation about current events.Excellent Student is nearly fluent and can understand and respond to difficult questions including abstract terms. Will have no problem communicating upon arrival.Good Student can understand most conversation. Responds slowly at times, but with appropriate an