2+i Industry-Academia Collaboration Program, 2019 Fall Semester

Application Form
http://2plusi.csu.edu.tw/
Program list: tick ONE program ONLY
□ 1.Mechanical Engineering Program-CSU □ 6.Information Engineering Program-KSU

□ 2.Mechanical Engineering Program-NCUT □ 7.Tourism and Leisure Program-HWU

□ 3.Mechanical Engineering Program-NKUT □ 8.Hospitality & Hotel Program-JUST

□ 4.Mechanical Engineering Program-LIT □ 9.Electronic Engineering Program-LHU

□ 5.Civil Engineering Program-CSU □ 10.Electronic Engineering Program- HUST

Please type or print clearly in English

Applicant

English name

Chinese Name
picture
Identification No.

Passport No.
□ Male
Birthday (YYYY/MM/DD) / / Sex
□ Female
□ Married
Telephone Marital Status □ Single

Home Address ：

Mailing Address ：

E-mail：

Line ID： WhatsApp ID：

Parent’s name / Relationship Mobile of Parents

Educational Background

Previous Education School Name Major Graduation Date School’s City

English Language Proficiency

□ TOEFL score: 。 □ TOEIC score: 。

□ IELTS score: 。 □ else: 。
I certify that all the information I provided in this application is correct and complete, and understand that
any misrepresentation will result in the termination of admission.
Signature: Date: