4/8/2015http://iczu.zju.edu.cn/zjdxlxszsxt/lxsTjdy.do?act=print 1/21. /Passport Name/Family NameDE LA VEGAENCINAS/Given Name IGNACIO 2015007415 Application for Admission to Zhejiang University (Language Program)2. /Name in Chinese (if have)3. /Nationality /Spain/Passport No. 108927XDC4. / Date of birth 1990/10/27 /Gender /Male5. / Place of birth /SpainSalamanca6. /Marital Status /Single /Occupation7. /Native language Spanish /Religion8. /State of Health optimal /Height169cm9./Highest Degree /Bachelor /School University of Salamanca10. / Current Employer or School11. / Permanent Address & Tel C/ Hernn Corts No5 Salamanca Spain+3492325180212. / Address to Receive Admission Documents & Tel liulangge sandongge3danyuan703+86138932654413. / Present Address & Tel liulanggesandongge3danyuan703+86138932654414. /Fax /Email ignacio.vegen@outlook.com15. /Language Proficiency:/Chinese/FairHSK: HSKB/Elementary levelGrade B/Chinese study hours 200/above 200/English:/Excellent /Level:/ others /Mark: /Other Language German, French16. /Proposed Study Plan at Zhejiang University:/Student Category:/Chinese Language Program/Duration of Specified Study Program: /from: /Year 2015/Month 09 /to: /Year2015 /Month0117. /Requirement for Residence:/Arranged by School18. /The Guarantor Charging Your Case in China:/Name /Tel /Address4/8/2015http://iczu.zju.edu.cn/zjdxlxszsxt/lxsTjdy.do?act=print 2/219. /Family Members of the Applicant:/Relationship /Name / Age /Employment /Tel /AddressFather Jacinto de la Vega 51 Officer +34647716809Mother Teresa Encinas 51 entrepreneur +34923251802Sister Esther de la Vega 28 entrepreneur +34610938189/ Please provide yourapplication materials as required. Whether the candidate is accepted or not, all the application materials will not bereturned./I hereby affirm that:1/All the information given in this form is true and correct;2/ I shall abide by the laws of China and theregulations of the school, and follow the teaching programs arranged by the university./Applicant's Signature:/Date(/The Application Is Invalid Without the Applicant's Signature)