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I hope to live in AVRDC dormitory: Yes No:Tel (O): Fax (O): E-mail (O): Tel (H): Fax (H): E-mail (H): ...

     APPLICATION FOR UNDERGRADUATE TRAINING at AVRDCThe World Vegetable Center P.O. Box 42, Shanhua, Tainan, Taiwan 74199, Republic of China 声明:本文档Tel: (06) 583-7801 ext. 503 Fax: (06) 583-0009

    E-mail: 由山东电建(sddianjian)

     Home page: 上传到豆丁网 聯絡地址:74151台南縣善化鎮益民寮60 (),若有侵害 亞蔬世界蔬菜中心 全球技術拓展 您的权益,请发站内消

     Photograph (digital image acceptable) **Note: Please type or print all entries in English 息。 ===================================================================


    Field of Special Interest

    Write “1” for first choice, “2” for second choice, etc. ( ) Biotechnology ( ) Nutrition Science ( ) Crucifer Breeding ( ) Crop & Ecosystem Management ( ) Bacteriology ( ) Cucurbit Breeding ( ) Entomology ( ) Mycology ( ) Legume Breeding ( ) Genetic Resource Conservation ( ) Virology ( ) Bulb Allium / Pepper Breeding ( ) Global Technology Dissemination ( ) Socio-economics ( ) Tomato Breeding ==========================================================================================

    Personal Date submitted (d/m/y):

    Family Name Given Name Name in Chinese Full Name: Present (in English) Address:

    (in Chinese)

    Home Address: (in English)

    (in Chinese)

    Citizenship: Place of Birth: Date of Birth: / / (D/M/Y)

     Yes No I hope to live in AVRDC dormitory: Sex: M F

    : Tel (O): Fax (O): E-mail (O): Tel (H): Fax (H): E-mail (H):

I am presently a JUNIOR SENIOR at the

     (name and address of school)

    I am majoring in

    (department/discipline) I expect to graduate on


    1 Feb 2009

2 Feb 2009

English Proficiency: Excellent Good Fair Poor

    Attach English Version of University Transcript 請附上大學在校成績單(英文版) Study Plans

    Subject of study or investigation you would like to conduct:

Reasons for selecting this particular topic:

    Describe briefly any disorders or physical defects which might interfere with your ability to complete the training program:

Emergency Address

    Give the name and address of the person to notify in case of emergency:

    (in English) Name Relationship: Tel: (in Chinese)

    (in English) Address (in Chinese)

    Signature of Applicant Sponsor

    Signature of professor and/or sponsor. Please print name under signature.

    Signature Title

    Name Address

    3 Feb 2009

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