Applying for which program?:*
—Wilson Medical Exchange–For medical positionsVautrin Education Exchange–For education positionsRabe Business Exchange–For business positionsOther–For all other positions
Chinese Name:*Please enter your Chinese name in both 汉字 and Pīnyīn.
English Name:*Please enter your English first and last name. If you do not have an English last name, use your Chinese Surname (example: Lisa Wu).
Nationality:*Please enter your majority or minority.
Registered City of Permanent Residence:*Please enter the city where you are registered as a permanent resident.
Date of Birth:*Please enter your birthdate in the form yyyy-mm-dd (ex: 1997-12-02).
Mobile Phone:*Please enter your 11-digit mobile phone number.
Social Network:Optional: Please enter your WeChat and/or QQ IDs.
Email:*Please enter your email address in the form “firstname.lastname@example.org”.
University:*Please enter your university’s name and campus.
Academic Major:*Please enter the academic major that you are pursuing or have attained.
Year in Degree Program:*
Years of Teaching Experience:*
Types of Teaching Experience:*Please list the types of teaching you have performed (Ex: Elementary, High School, University, etc.)
Type of career you intend to pursue in the future (be specific):*Please share the type of career you plan to pursue in the next 3-5 years.
Please list three other career interests:Please share other career-related fields, roles or responsibilities you want to explore.
Do you currently have a valid passport?*Please indicate whether you have a passport that is valid for at least 6 months after your desired period of participation in this program.
Do you currently have a valid US visa?*
Have you ever been DENIED a visa to the United States?*
Please list any of your allergies or medical conditions:*Please indicate any allergies or medical conditions that may impact your participation in this program.
Why are you interested in this exchange program?*
Why do you want to pursue the career you indicated above?*
What is a significant challenge facing the Chinese professionals in your field, and how could you help improve it?*
How did you hear of the program?*Please share who referred you to this program, or where you heard about it (ex: A friend(name), WeChat, Internet, etc.)
If I am accepted to the CONNECT Exchange (CE) program, I agree to the following:
If I do not abide by the above guidelines, I forfeit my participation in the Connect Exchange and will bear the financial burden for my actions including the program fee and an early return flight back to China if the program leaders determine an early return is necessary.
By checking this box, I agree to all of the above:*
Personal Interview: The final step in the selection process is a personal interview in English with an exchange program representative. If chosen for an interview, you will first be contacted with appointment details.