设为首页  |  加入收藏
 首页  新闻中心  校际交流  外教专教  出国出境  资料下载  关于我们 
欢迎光临太原工业学院外事办公室!
栏目导航
 工作动态 
 通知公告 
站内搜索:
 
 
 
通知公告
当前位置: 首页>>新闻中心>>通知公告>>正文
美国加州州立理工大学创新创业能力发展项目报名表
2017-09-29 11:28     (点击: )

C A L I F O R N I A  S T A T E  P O L Y T E C H N I C  U N I V E R S I T Y ,  P O M O N A

 

Global Education Institute

 

College of the Extended University

 

 

APPLICATION FORM

 

Program: Student Innovation & Entrepreneurship Program (SIED)

Term: Winter 2018

 

Application Due: December 15, 2017


 

1 PERSONAL INFORMATION

 

 

Please type or clearly print your name exactly as it appears on your passport. Submit a copy of your

 

passport information page.

 

Last Name (family name):____________________

 

First Name (given name):____________________

 

Gender: Male Female

 

Date of Birth: _______/_____/_________

Month Day Year

 

Country of Birth: ___________________________

 

Country of Citizenship: ______________________

 

Native Language: __________________________

 

Name of College/University: _________________

 

_________________________________________

 

Year: 1st 2nd 3rd 4th Graduate

 

Major: ___________________________________

 

Phone Number: ____________________________

 

Cell Phone: _______________________________

 

Email: ___________________________________

 

Social media that you use most often (WeChat,

 

WhatsApp, Line, etc):

 

_________________________________________

 

ID: ______________________________________

 

Mailing Address:

 

Name: ___________________________________

 

Street Address: ____________________________

 

_________________________________________

 

City: _____________State/Province: ___________

 

Zip Code: __________ Country: ______________

 

Phone: ___________________________________

 

Home Address (leave blank if same as mailing address):

 

Street Address: ____________________________

 

_________________________________________

 

City: _____________State/Province: ___________

 

Zip Code: __________ Country: ______________

 

Permanent Telephone: ______________________

 

 

3 FINANCIAL INFORMATION

 

 

For visa interview purposes, we recommend that you prepare a copy of a bank-certified financial statement on official bank letterhead to prove that you have sufficient funds to cover tuition and living expenses during the program study period. All funds must be stated in U.S. dollars, and the statement must be dated less than six months before the date the applications is received.

 

Source of Financial Support (minimum $6,000):

 

Parent/family member Friend Self Other

 

Contact Information of Financial Sponsor:

 

Name: ___________________________________

 

Street Address: ____________________________

 

_________________________________________

 

City: _____________State/Province: ___________

 

Zip code: __________ Country: _______________

 

Phone: ___________________________________

 

Declaration of Financial Sponsorship:

 

I certify that I will assume full financial responsibility (including educational and living expenses) for the applicant while he/ she is enrolled in the Student Innovation &

 


 

 

Please note: Date and prices are subject to change with prior notice.

 

THE CALIFORNIA STATE UNIVERSITY Bakersfield, Channel Islands, Chico, Dominguez Hills, East Bay, Fresno, Fullerton, Humboldt, Long Beach, Los Angeles, Maritime Academy, Monterey Bay, Northridge, Pomona, Sacramento, San Bernardino, San Diego, San Francisco, San Jose, San Luis Obispo, San Marcos, Sonoma, Stanislaus


C A L I F O R N I A  S T A T E  P O L Y T E C H N I C  U N I V E R S I T Y ,  P O M O N A

 

Global Education Institute

 

College of the Extended University

 

Entrepreneurship Program at California State

Polytechnic University, Pomona.

 

Signature: __________________ Date: _________

 

Relationship to Student: _____________________

 

(example: mother/uncle/friend/etc.)

 

 

 

4 PAYMENT PROCEDURE

 

 

Your program fee payment of $2,980 is due by

January 18, 2018. You can choose any payment

type below:

 

 Online transfer (Flywire): https://www.flywire.com/pay/ceu

 

 Cashier’s check or money order payable to Cal Poly Pomona Foundation, Inc.

 

 Wire Transfer (a $30 transaction fee will apply)

 

 

5 SIGNATURE

 

 

I certify that the information on this entire form is

correct to the best of my knowledge. I agree to pay

the required program fee.

 

Student’s Signature: ________________________

 

Date: ____________________________________

 

 

 

6 SUBMISSION INFORMATION

 

 

Please submit the completed Application Form

and a copy of your passport information page

by email to:

 

Vivienne Shen, Ed.D.

Program Developer/Manager

 

Global Education Institute

College of the Extended University

California State Polytechnic University, Pomona

 

Phone: +1 (909) 869-2256

Fax: +1 (909) 869-5077

Email: xshen@cpp.edu

 

3801 W Temple Ave., Bldg. 220A-203

Pomona, CA 91768

 

USA

 

Please note: Date and prices are subject to change with prior notice.

 

THE CALIFORNIA STATE UNIVERSITY Bakersfield, Channel Islands, Chico, Dominguez Hills, East Bay, Fresno, Fullerton, Humboldt, Long Beach, Los Angeles, Maritime Academy, Monterey Bay, Northridge, Pomona, Sacramento, San Bernardino, San Diego, San Francisco, San Jose, San Luis Obispo, San Marcos, Sonoma, Stanislaus

附件【SIED Application.docx
关闭窗口
太原工业学院 | 太原工业学院电子政务 | Taiyuan Institute of techno... | 国家留学基金委员会 | 山西省留学人员管理委员会 | 山西省教育厅 | 东方国际 | 山西省出国留学人员服务中心

版权所有:太原工业学院国际交流合作处   联系电话:0351-3566078
地址:山西省太原市尖草坪区新兰路31号行政楼418    邮政编码:030008