Guizishan Fellowship Application
Applicant Information	
Applicant’s Full Name:
	Birth Date
	Place of Birth
	Male
	Female
	
Affiliation with Yale:	
Residential College and/or Graduate/Professional Program and Year(s):
	Major or Field of Study:
	
Current Mailing Address: 	
Line 1
	Line 2
	City
	State
	Zip Code
	
Permanent Mailing Address: (if different from above)	
Line 1
	Line 2
	City
	State
	Zip Code
	
Best Phone Number at Yale:
	Other Phone Number:
	Email Address:

How did you hear about this Fellowship?

[   ] Email Announcement	[   ] Poster	[   ] Friend	[   ] Professor
[   ] Other (please explain)	
Names, titles, and contact information for recommenders, including one who will assess your Mandarin ability:	
Name
	Title
	Phone Number
	Email
	
Name
	Title
	Phone Number
	Email
	
Name
	Title
	Phone Number
	Email

1.	Mandarin level (Please limit all responses to questions 1-5 to the space provided.)	
Years studied:		
Area(s) of Proficiency:	    [   ] Conversational    [   ] Technical (Academic)    [   ] Technical (Other: _________________________)
    [   ] Formal / Professional    [   ] Classical	
Listening/Speaking:	    [   ] Survival    [   ] Functional in a wide range of settings         Additional comments:
    [   ] Functional in almost all settings    [   ] Native level	
Reading/Writing:	    [   ] Survival    [   ] Functional in a wide range of settings         Additional comments:
    [   ] Functional in almost all settings    [   ] Native level	

2.Teaching Experience	
Duration
(e.g. 2 yrs, June
2010-July 2012)	Organization	Position	Subject	Level of Students	

					

3. Employment, Public Service, and Volunteer Work	
Duration
(e.g. 2 yrs, June
2010-July 2012)	Organization	Position	Responsibilities	

				

				

4. Experience Abroad (Work, Travel or Study)	
Duration
(e.g. 2 yrs, June
2010-July 2012)	Destination(s)	Purpose	

			

			

5. Extracurricular activities and recreational interests (not already listed above):	

Please limit your responses for questions 6-9 to the number of characters indicated.

6.	PROJECT OBJECTIVES: Write a clear and detailed description of your project plan, your objectives, and your reasons for wanting to pursue them. Describe how you will utilize resources at CCNU to carry out your project.  [3000 characters max.]

7.	Personal Statement: Please share your current and future goals. Include information about your education, practical experience, special interests, and career plans. Describe any significant factors that have influenced your educational or professional development. [3000 characters max.]

8.	How have you worked or studied in China previously?  What do you think will be the greatest challenge in undertaking your project as a Guizishan Fellow at CCNU?  [3000 characters max.]

9.	The Yale-China Association is a community based on contributions by individual participants in the context of long-term institutional relationships. How do you anticipate contributing to this community – to CCNU, to the local community, and to Yale-China more broadly? What attracts you to these opportunities for service?  [1800 characters max.]