Application Form for International students Admission to Changchun University of Science and Technology
130022 Tel: 86-431-85583291/85583294
Address: International Education and Exchange College Fax: 86-431-85309336/85309021
Changchun University of Science and Technology E-mail: ieec_cust@[Link]
Changchun, Jilin P.R. China 130022 [Link]@[Link]
1. Full Legal Name: . Muhammad Kabir .
SURNAME GIVEN NAME
2. Chinese Name (if any):. X X .
SURNAME GIVEN NAME
3. Country of Citizenship: NIGERIA 4. Marital Status: Single ◻Married
5. Passport No.: A50572113 6. Gender: Male ◻Female
7. Date of Birth: 2002 / 12 / 16
8. Place of Birth: KANO
9. Post Address to receive Admission Letter:
468 Tudun Fulani, Musa jidda street
Permanent EMAIL muhammadpassmark@[Link] Fax X Telephone
+2347014629114 .
10. Program: ◻ Chinese Language program ◻Bachelor Master ◻Doctor
11. Major: SOFTWARE ENGINEERING Duration of Study: from 03 / 2020 to 02 / 2024.
12. Highest Academic Degree: ◻High School ◻ In College ◻ Bachelor
Master’s Degree ◻Doctor’s Degree ◻ Others .
13. Last School Name INTERCONTINENTAL SCHOOLS KANO .
14. Language Proficiency
Chinese: ◻ Excellent ◻ Good◻ Fair ◻ Poor None
HSK / Level of HSK Test (if any) X .
English: Excellent ◻Good ◻Fair ◻ Poor ◻ None
Level of TOEFL and IELTS Test (if any) .
15. Emergency Contact MRS FATIMA ABDULLAHI Relationship with the applicant MOTHER .
Address 469 TUDUN FULANI, MUSA JIDDA STREET Tel +2348030944072
I hereby affirm:
1. I declare that the information and documents provided in support of this application are accurate and complete. I
understand that the information and documents will be used in the admission decision process and that any
misrepresentation will disqualify my application for admission and enrolment to Changchun University of Science
and Technology.
2. I shall abide by the laws of the Chinese government and the regulations of the university.
Signature Date . 15-12-2019 .