2017 YingHua in Beijing Application Form
* indicates a required field.Thank you!
Last Name (*)
First Name (*)
Gender (*)Male    Female
Date of Birth (yyyy/mm/dd)(*)
Country(*)
School
Street Address
City
State (Province)
Major Contact Mother    Father   Guardian
Major Contact Name (Last, First)
Major Contact Email(*)
Major Contact Telephone
Passport Number
Passport Expiration Date
Have you participated in any international program?Yes   No
If Yes, Please State:
USA Contact Name (Last, First)
USA Contact Email
USA Contact Telephone
USA Contact Address (Street, City, State)