注意事项:

本表可复印使用。

请在所选项目框“□”内划“√”表示选择。

本文须用中文或英文印刷体填写，没有的请填写“无”，其他文字或缺项填写无效。

Notes：

If necessary, please make a copy of this form and fill it out.

Please indicate with “√” in the blank chosen.

Please write clearly in PRINT CAPITALS OR LETTERS (Chinese or English ).

Please write “None” if not applicable. An incomplete application or application completed in language other than Chinese or English will be invalid.

• 护照姓名： 姓/Family Name 名/Given name Name in Passport:									照片 Photo
  中文名/Chinese Name:		性别/Gender: □男/Male □女/Female				国籍/Nationality:
  护照号码/Passport No.:				护照有效期/Passport Valid Until:
  出生日期: 年 月 日 Date of Birth:            y.     m.       d.					出生地点： 城市/City 国家/Country Place of Birth:
  宗教信仰/Religion:		母语/Language:			婚姻状况/Marital Status:				职业/Occupation:
  固定住址/Permanent Address (Street, City, Country,   Postcode, Home Tel):
  联系电话/Phone No. In Home Country:					电子邮件/Email:
  紧急联系人及电话/ Emergency contact person: Tel :
  最后学历Highest Academic Degree Obtained
  学校名称 Name of School			在校时间 Duration（from/to）				主修专业 Major		所获文凭 Diploma/Degree
  语言能力 Language Proficiency	汉语/Chinese			□ 母语/Native □ 流利/Fluent □ 良好/Advanced □ 一般/Basic □ 不会/None				语言考试/Test(s) Taken: HSK: Level________ Others:________
  学习计划 Study Plan	申请类别/项目 Type of Application or Program			□ 交换学习/Exchange □ 语言学习/Chinese Language □ 专科学习/Diploma 专业/Major________
  	计划学习期限 Duration of Study			自 年 月 至 年 月 From          y.      m.       to          y.      m.
  申请人保证/I hereby affirm that: 1．申请表中所填写的内容和提供的材料真实无误。 All   information and materials given in this from are true and correct. 2．在华期间遵守中国法律法规，不从事任何危害中国社会秩序并与本人来华学习身份不符的活动。 During   my stay in China, I shall abide the laws and decrees of the Chinese   government, and will not participate in any activities in China which are   deemed to be adverse to the social order of China and are inappropriate to   the capacity as a student. 3．在学习期间，遵守学校的校纪校规，全力投入学习，服从学校的教学安排。 During   my study in China, I shall abide the rules and regulation of the host   college, and concentrate on my studies and researches, and follow the   reaching programs arranged by the college. 4．来华后到校报到注册，不无故要求变更学校和所学专业；  After arrival in China，I shall not apply to change in my field or college of study   without valid reasons； 5．按规定期限修完学业，按期回国，不无故在华滞留。 I shall return to my home country as soon   as I complete my scheduled program in China, and will not extend my stay   without valid reasons
  申请者本人签字/Signature of the applicant: 日期/Date:

补充说明/ Notes：

申请专科学历学习者，请务必随本表提交以下材料：Applicants of diploma study need submit following documents with the application form:

1）最后学历证书及公证件扫描件；Scanned Copies of Highest Academic Degree Obtained, notarized document of Highest Academic Degree Obtained;

2）成绩单及公证件扫描件；Scanned Copies of transcripts, notarized document of transcripts;

3）护照的扫描件；Scanned Copies of passport;

4）体检表的扫描件；Scanned Copies of Physical Examination Record for Foreigners;

5）无犯罪记录证明的扫描件；Scanned Copies of Non-Criminal Record;

6）证件照电子照片；Digital ID photo;

7）HSK3级证书的扫描件。Scanned Copies of HSK3 Certificate .

*以上材料均须为中文或英文。

All documents above should be in (be translated into) Chinese or English.