Office Use Only

Level: BASIC ______ ( ) Basic Mock Test Date: __/__/__ (m/d/y) ELE. -INT. ___ ( ) Ele-Int. Mock Test Reg. No. _______

HSK Test-Taker Registration Form

(Please PRINT, and use your REGISTERED name on your photo ID)

Name (Chin.): __________ Name (Eng.): ___________________ ID#____________

Citizenship: ______________ Date of Birth: __/__/__ (m/d/y) Gender: M F

Current Address: Permanent Address:

________________________ ____________________

________________________ ____________________

________________________ ____________________

Tel: _____________________ Tel: ________________

Fax: _____________________ Fax: _______________

E-mail: __________________

Occupation/Student: _______________________________________

Institution/School/Organization: ____________________________

Language Background:

Years of Chinese Study: <0.5 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 >5

Native Language:_________________________________________________

Foreign Languages Other Than Chinese and English:_______________________

Level of test to take: Basic: ____ Elementary & Intermediate: ____ Advanced _____

If you had taken HSK,

Where__________________ Level____________________

When___________________

If you want to have your HSK result be reported to any organization/school, please provide the following:

Address:__________________________

_________________________________

_________________________________

If qualified, would you like to accept an HSK Winner Scholarship to study Chinese or a literature/arts/social science major in China for one year? Yes ___ No ____