2015斯坦福大学国际青年计划申请表SIYPApplication and Evaluation Form

:1. Students Information

Q1:Name in Pinyin

Q2:Name in Chinese

Q3:Date of Birth

Q4:Gender

Q5:Current Grade

Q6:School Attended

Q7:School City and Province

Q8:Teaching Language (Is English the key teaching language?

Q9:English Test (if applicant)

Q10:Email address

Q11:Mobile

Q12:Wechat/QQ (if available)

:2. Guardian/Parent Information (Either parent)

Q13:Name

Q14:Company Title

Q15:Relationship

Q16:Mobile

Q17:Email

Q18:Wechat / QQ (if available)

:3. Profile QuestionsPlease answer all of the questions below:

Q19:What do you hope to gain by participating in the Stanford InternationalYouth Program? What aspects of the program appeal to you the most?

Q20:What do you like, or dislike, about school? Feel free to use examples fromyour personal experience to help with your description.

Q21:Please list any extra-curricular academic activities in which you haveparticipated during the last three years, in order of their importance to you.

Q22:Have you attended any international summer program before?

Q23:If YES,which one and when?

:4. English Writing TestPleasepickONEofthepromptsbelowandwriteanessay(around500words).1. Recount a specific time or incident when you experienced failure. How did it affect you, and what lessons did you learn?2. Describe an accomplishment or a specific time that you feel very proud of. Why is it important to you? How did it affect you?3. Reflect on a trip or project that you have recently completed. Why did you do it? What have you learnt from the entire process.

Q24:Essay Writing

:5. Project AssignmentA famous Stanford Math professor is visiting China, and he has kindlyreserved a day to meet with interested students. You have been chosen asthe student representative to organize the event.How would you structure the event to make the most impact at your school orthe community? What are the objectives? Format?(*Note: When you plan for this event, youcan make up some assumptions asnecessary and just state clearly in your plan.)

Q25:Project Assignment Writing Area

Q26:6. Honor CodeI have truthfully represented myself on this application in my answers to the questions and in the work that I am submitting. I attest that all responses to the questions on this application are my own. I understand that any misrepresentation in my application materials is grounds for the Stanford International Youth Program to revoke an offer of admission.

Q27:是否持有有效护照（至少有3页空白页；自入境美国之日计算护照有6个月以上有效期）