Huron Chinese Program — Placement Request Form

Huron Chinese Program — Placement Request Form
Student Identification
I am requesting Placement & Special Permission to take the course, CHN*
Given Name*

Given (First) NameFamily (Last) Name
Preferred/Chosen Name*

Preferred NameChinese Name (In Chinese/Hanzi (漢字))
9 Digit UWO Student ID*
Year of Study
UWO Email Address*
Primary Phone Number
Please enter a valid phone number.
Alternative Phone Number
Please enter a valid phone number.
Previous General Education
City of Elementary School
Country (or SAR) of Elementary School
*SAR = Special Administrative Region
City of High School
Country (or SAR) of High School
*SAR = Special Administrative Region
City of University
Country (or SAR) of University
*SAR = Special Administrative Region
General Chinese Experience
Describe briefly any experiences you have with Chinese language: Such as friends who speak Chinese; websites which use Chinese; having lived/visited/worked in a Chinese-speaking environment. Please include details such as years (experienced), cities (lived/worked/visited), activities (performed), etc.
Related Language Background - Social

Recently, for six months or more, I lived in a community where they spoke:
Which Language?
What Country/SAR?
*SAR = Special Administrative Region
Besides that, I lived in a community where they spoke:
Which Language?
What Country/SAR?
*SAR = Special Administrative Region
I am most comfortable speaking:
Which Language?
Language Background - Personal

My experience with spoken Chinese
My family members speak
They speak it to me (% of the Time)
Others speak it to me (% of the Time)
I speak it (% of the Time)
My additional experience
They also speak
To me (% of the Time)
Others speak it to me (% of the Time)
I use it (% of the Time)
My ability in written Chinese
I recognize fewer than...
# of Characters ((漢字)
I can write fewer than...
# of Characters (漢字)
Previous Formal Chinese-language study -- your most advanced level
At Huron College, I studied
In the Year
Also At Huron College, I studied
In the Year
Not at Huron, I formally studied
Studied From
Studied To
Number of classroom hours per week
Name of highest level course
Textbook title
Name of School
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Website URL or Phone Number of School
Should be Empty:

Huron Chinese Program — Placement Request Form

Student Identification

Previous General Education

General Chinese Experience

Related Language Background - Social

Language Background - Personal

Previous Formal Chinese-language study -- your most advanced level