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2010 Online Application
for Language Course
To apply for language course, you need be aged above 16 (on arrival). Application needs to be submitted at least 4 weeks before intended start date. Late applicants are accepted on case to case basis.
Make sure you have read Price & Schedule. If you prefer, you can print and send the PDF application form by email or fax.
Program Data
Program you’d like to apply for*   Guide
General Chinese
General Chinese 20
Combined 20+5
Combined 20+10
Individual 20
Private Tuition (Flexible time)
Business Chinese
Business Chinese 20
Individual 20
Private Tuition (Flexible time)
HSK Preparation
HSK Preparation 20
Private Tuition (Flexible time)
Start Date*   Guide
Jan 11
Feb 08
Mar 08
Apr 05
May 03
May 31
Jun 14
Jun 28
Jul 12
Jul 26
Aug 09
Aug 23
Sep 20
Oct 18
Nov 15
Dec 13
Others
Duration*   Guide
weeks
Finish Date*
For Private Tuition Only  Guide
How many lessons
50 lessons 100 lessons 150 lessons 200 lessons
Others
How many students
1 student 2 students 3 students 4 students
5 students  
Airport Pick-up*  Guide
No Yes
Arrival Date
Coming from (City) Airport of Arrival
Airline Flight No
Arrival Time    
Housing Arrangement*   Guide
No Yes
Private studio apartment Single room in shared apartment
Others(please specify)
Check-in Date Check-out Date
       
Applicant Information
Personal Information  Guide
First Name* Family Name*
Gender* Male Female
Nationality* Native language*
Date of Birth* day month year
Tel No.*
Country Area Phone
Mobile No.
Country Area Phone
Address*
(street) (city)
(zip code) (country)
Company/School
Occupation/Grade
Website
Passport Number
(Provide as soon as possible if you don’t have one yet)
Current level of Chinese*
Total Beginner Beginner Elementary
Pre-intermediate Intermediate Advanced
Health Condition*
Any medical conditions(Allergies, asthma, illnesses, previous injuries, disabilities)
None Yes
(please specify here)
Symptoms Medications
Emergency Contact
Name* Relationship*
Tel No.*
Country Area Phone
Mobile No.
Country Area Phone
Taken any programs with Mandarinrocks before?*
None Yes
(please specify here)
How did you hear about us? Please specify here*
Yahoo Search Google Search
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Agent
Company
Payment
To confirm your booking, a deposit of 80USD/60EUR deductable from the total (NON REFUNDABLE) must be paid to MandarinRocks. This deposit is not an additional cost. The balance must be paid at least 4 weeks before arrival. Students currently in Shanghai can pay by credit card or cash in person at school. Students from other cities or abroad can only pay by bank transfer. We will contact you with a confirmation email within the next 48 hour after your application is submitted. The deposit and payment is payable at that point, not now.
Other Information You Need Us to Know
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Contact Details
MandarinRocks (Shanghai)
Tel +86 21 62550715
Fax +86 21 62883988
E-mail: info@mandarinrocks.com
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