国际学生入学申请表
Application Form for International Students
注意：请用中文或英文填写此表格。请用电脑打印或用蓝色或黑色钢笔认真书写表格内容。请在所选项框内划‘√’表示。不按规定填写的表格将视作无效。
Note: Please complete the form in Chinese or English. Fill the form on PC or write neatly in black or blue ink. Tick where applicable ☑. Any form that does not follow the notes will be invalid.
护照名（英语） Full Name with Middle Initial in English according your passport | 姓 Family Name: |
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中间名 Middle Name: |
名 Given Name: |
中文名 Chinese Name |
| 国籍 Country of citizenship |
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本国身份证号码 ID No. |
| 护照号码 Passport No. |
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性别 Gender | □ 男 Male □女 Female | 护照有效期 Valid until | 年/yy 月/mm 日/dd |
出生日期 Date ofbirth | 年/yy 月/mm 日/dd | 出生地点 Place of birth | 国家Country ________________________ 城市City ________________________ |
宗教信仰 Religion |
| 婚姻状况 Marital Status |
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职业 Occupation |
| 学习或工作单位 Institution/Employer |
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电话、手机 Tel & Cell phone |
| 电子邮件 E-mail |
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邮政编码 Zip Code |
| 电话/传真 Tel/Fax |
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录取通知书邮寄地址 Mailing address for the Admission package | 如地址有变，请及时告知。Please inform the International Students Office for any change of this address.
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收件人 Receiver |
| 邮政编码 Zip Code |
| 电话/传真 Tel/Fax |
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学习经历（从中学开始填写） Educational background（From SecondarySchool） |
学校名称 Institutions | 在校时间 Years attended (from/to) | 主修专业 & 所获证书 Field of study & Diploma received | 证书编号 No. of Diploma | 优点或特长 Specialities |
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工作经历 Employment Record |
工作单位 Employer | 起止时间 Years attended (from/to) | 从事工作 Occupation | 职务 Position |
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语言 Language |
母语 Mother Tongue |
| 其他 Others |
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汉语Chinese | HSK：_______级 |
英语English | ¨基本 ¨熟练 ¨优秀 |
推荐单位Recommended by |
推荐单位 Recommended by |
| 联系人 Contact person |
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联系地址 Address |
| 电话/传真 Tel/Fax |
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在六盘水师范学院的学习计划 Study Plan at Liupanshui Normal University (please click what you plan to study) |
申请类别Category | 申请学习专业 Major or field of study |
语言进修生 Language Program |
□ 初级汉语语言/Preliminary Chinese Language Program □ 中级汉语语言/Medium Chinese Language Program □ 高级汉语语言/Advanced Chinese Language Program |
本 科 生 Bachelor Program | 申请专业一/Major 1： 申请专业二/Major 2： |
是否服从调剂/Accept other majors or not?： □ 是/Yes □ 否/No |
申请学习时间Duration of study |
自/From | 年/yy 月/mm | 至/To | 年/yy 月/mm |
经费来源Financial Support |
□自费 Self-support | 保证人姓名Guarantor's name： 与申请人关系Relationship with the applicant： 地址Address： 10 bag building 308 number 11 Bayanhongor Mongolia, 976-99025464
电话/传真Tel/fax： 保证人签名Guarantor's signature： |
□奖学金 Scholarship |
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家庭情况Family Status |
称谓 Appellation | 姓名 Name | 职业 Occupation | 联系电话 Tel | 电子邮件 E-mail |
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在华事务联系人Contact person in China |
姓名 Name |
| 电话、手机 Tel & Cell phone |
| 电子邮件 E-mail |
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工作单位 Employer |
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联系地址 Address |
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经济担保人或机构Economic guarantor or institutions |
姓名 Name |
| 电话、手机 Tel & Cell phone |
| 电子邮件 E-mail |
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工作单位 Employer |
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联系地址 Address |
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申请人保证/I hereby affirm that:
1、上述各项中填写的信息和提供的材料真实无误。如因个人信息错误、失真造成不良后果，责任由本人承担。 All information and materials provided are factually true and correct. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation or expulsion, should the information I’ve certified be false. 2、在华期间，遵守中国的法律和法规，不从事任何危害中国社会秩序的，与本人来华学习身份不相符合的活动； During my stay in China, I shall abide by the laws and decrees of the Chinese government, and will not participate in any activities which are deemed to be adverse to the social order in China and are inappropriate to the capacity as a student; 3、在学期间，遵守学校的校纪校规，尊重学校的教学安排。 During my study in China, I shall observe the rules and regulations of the university, and will concentrate on my studies and researches, and will follow the teaching programs provided by the university.
申请人签字（Applicant’s Signature）：__________________ 日期Date：_________________ (无此签名，申请无效。The application is invalid without the signature.) |
预祝您申请成功!We wish your application success!