REGISTRATION FORM FOR FUNHOUSE E.CLUB GROUP LEADER Dao Duy Tu high school
Part I. Candidate information Please provide your personal information by filling in the blank: Full name: Last
Middle
First
Address: Number
Current class
Street
District
School Dao Duy Tu high school
City/Town
Gender M/F
Home Phone
Date of birth
Cell
Month
Day
Email address
II. Foreign language proficiency
Please provide your information by filling in the blank:
Your English Grade Point Average:
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Year
Please rate your English proficiency from 1 to 5 (with 5 indicates the highest level) in the following areas: A. B. C.
Speaking Listening Writing
1 1 1
-
GPA (if available): Please rate your language proficiency from 1 to 5 (with 5 indicates the highest level) in the following areas:
A. B. C.
Speaking Listening Writing
1 1 1
2 2 2
2 2 2
3 3 3
3 3 3
Please list up to 3 awards/prizes you have received in English 1. 2. 3.
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4 4
5 5 4
4 4 4
5
5 5 5
Part III. Extra- curricular activities
Please list up to 5 extra-curricular activities you have participated in following chart:
Activity
Dates of participation
Positions held
Part IV. Time you can spend with us Please be specific about the time you can spend with us in the following chart. If your schedule in a particular time is full, please leave it blank. Day Monday Tuesday Wednesday Thursday Friday Saturday Sunday
From: From: From: From: From: From: From:
Morning To: To: To: To: To: To: To:
From: From: From: From: From: From: From:
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Time Afternoon To: To: To: To: To: To: To:
Part V. Other
Write an essay (200-300 words) The importance of co-operation in life.
Please answer all the questions below using no more than 100 words: 1. How do you understand the meaning of being a leader?
2.
Why do you want to become a leader and what will you do to help other members?
3.
Tell us more about yourself (your pastime, your dream,etc).
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