姓 Family Name: |
名 Given Name: |
照片 Photo : |
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护照号码 Passport No.: |
护照有效期 Date of Expiry: |
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出生日期 Date of Birth: |
性别 Gender : |
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国籍 Nationality: |
婚姻状况 Marital Status: |
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最后学历 ¨高中 ¨专科 ¨大学 ¨研究生 ¨博士 Educational Background: ¨ High school ¨ Diploma ¨ Bachelor ¨ Master ¨PhD |
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已取得何种学位 Degrees Obtained: |
职业 Occupation: |
宗教 Religion: |
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签证办理使领馆 Embassy or Consular Where you plan to get your visa in your country. Please indicate a city: |
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通讯地址 ______国家,________城市,__________区,___________街道, ________门牌号。邮编_______ Address:_________(Country)__________(City)______________(District)______________________(Street)______________(Building&Room No). ____________(Post code). |
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电话号码 Telephone No.: |
电子信箱 E – mail: |
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您的紧急联系人/担保人(如:父/母或其他亲属) Emergency contact person/guarantor (i.e. father/mother or other relatives): 姓名(fullname) _________________________________________________________ 您的紧急联系人/担保人电话his/hertelephonenumber ________________________ 您的紧急联系人/担保人电子邮箱his/here-mail _____________________________ |
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现有汉语水平/ TicktheappropriateboxtoindicatethenumberofChinesewordsyouknow. A None B about 600 C about 1200 D about 1800 E about 2500 F about 3000 |
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□语言生/ChineseLanguageStudent □少于一学期/ lessthan1 semester □一学期/1 semester □一年/1 year □多于一年/morethan 1 year * * * □学历生/Undergraduate Student: 申请专业/Major Applied for: |
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房间类型/Room Type: □单人间/Single Room □双人间/Double Room | |||
学习时间 自 年 月 至 年 月 Duration of Study: From Year Month To Year Month |
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申请人保证 1. 表中提供的情况是真实无误的 I hereby affirm that: All the information given in this form is true and correct. 2. 在中国留学期间遵守中国的法律和学校的规章制度 I shall abide by the laws of the Chinese Government and the regulation of the college. 申请人签名/Signature: |
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