NO.：
Beijing Oriental University
International Nursing College
Application Form
Student Name:
Spell:
Date of Application:
Name of Course：
1.Basic Information（Please according to the fact）
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Nationality： ID NO.：
Date of Birth： Household Registration：
Home Address： Correspondence Address：
Tel： Mobile：
E-mail： Fax： |
Additional Form:
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Parents/Tutor’s Name： Parents/Tutor’s Job：
(Father) (Father)
(Mother) (Mother)
Tel：
Fax：
E-mail：
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2. Educational Background:
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Secondary Education（Please enter details of all secondary schools you have attended with dates of entering and leaving the school） |
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Name and address of school |
Examination Passed
（Please attachment the examination’s copy） |
Dates：
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From To |
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From To |
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Third Level（Please enter details of all secondary schools you have attended with dates of entering and leaving the school） |
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Name and address of school |
Examination Passed
（Please attachment the examination’s copy） |
Dates：
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From To |
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From To |
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From To |
3. Language Competency（If have joined in IELTS or TOEFL, please attachment the score list and score list copy））
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Mother tongue:_________
Language of instruction at third level institution(if different) ____________
English Test Scores：IELTS________ TOEFL________ QPT________ OTHER________ |
4. Work Experience （If have）
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Type of work experience |
Firm/Organisation |
Dates |
Country |
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5. Other Information
6. Declaration
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I certify that the information given is accurate and complete. If my application is accepted, I undertake to observe the BOUINC regulations and to ensure full payment of fees and other liabilities.
Student’s signature： Date：
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FOR OFFICE USE ONLY
BOUINC hereby acknowledges receipt of the application
The above-mentioned student is ( ) accepted by BOUINC
( ) not accepted by BOUINC
Signed: Director of BOUINC Signed: BOUINC Representative
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Date: Date:
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