OPENING DOORS TO THE WORLD SINCE 1980!

CULTURAL HOMESTAY INTERNATIONAL

A N on-Profit Ed ucational Exchange Program

255 West End Ave, SAN RAFAEL, CA 94901, USA

(415) 459-5397 • Fax (415) 459-2182
E-m ail: chiw t@chinet.org • w w w .chinet.org

PROOF OF UNIVERSITY VACATION DATES

Agency Code________________

I certify that Mr./Ms. (participant’s name) _______________________,

born on (DOB) _____________ is registered in (name of the University)
______________________________ as a full time student for the
academic year ______ /_______ with summer vacation between (e.g.
25/Jun/2018 and ...) _____/______/________ and
_____/______/________.

Signature:________________________
Name ___________________________
Title ____________________________
Date____________________________
Official stamp/seal

USA • CANADA • JAPAN • KOREA • EASTERN EUROPE • Partners in 42 Countries on 5 Continents