中國(guó)科學(xué)院外籍青年科學(xué)家交流計(jì)劃管理細(xì)則

編號(hào)：中國(guó)科學(xué)院外籍青年科學(xué)家計(jì)劃推薦表CASYoungscientistsfellowship推薦單位名稱（蓋章） 外籍青年姓名 外籍青年國(guó)別申請(qǐng)來(lái)華期限D(zhuǎn)uration中國(guó)科學(xué)院國(guó)際合作局制年月日

外國(guó)青年科學(xué)家的基本情況姓名Name性別Gender國(guó)籍Nationality職位Title電話TelE-Mail傳真Fax研究領(lǐng)域(中英文)ResearchField(CH/EN)工作單位(中英文)Workplace(CH/EN)聯(lián)系地址Contactaddress

外國(guó)科學(xué)家簡(jiǎn)歷、主要學(xué)術(shù)和技術(shù)成就、在國(guó)外機(jī)構(gòu)和國(guó)際組織任職情況以及曾獲得的主要國(guó)際學(xué)術(shù)獎(jiǎng)(中英文)Resume,academicachievements,awards,internationalorganizationactivitiesetc.(bothinChineseandEnglish)外國(guó)青年科學(xué)家在我院工作計(jì)戈IJ安排外國(guó)科學(xué)家在我院期間的具體合作研究項(xiàng)目、學(xué)術(shù)交流、人才培養(yǎng)、擬解決問(wèn)題等活動(dòng)計(jì)劃Resume,academicachievements,awards,internationalorganizationactivitiesetc.(bothinChineseandEnglish)依托單位合作者的情況以及推薦意見(jiàn)聯(lián)系人員信息姓名HostPI性別Gender職務(wù)Title電 話TelE-Mail手機(jī)Cellphone傳真Fax

研究領(lǐng)域（中英文）ResearchfielddescriptionofhostPI(Ch/En)推薦單位意見(jiàn)以及相關(guān)承諾推薦單位負(fù)責(zé)人： （蓋章） 年月日專業(yè)局意見(jiàn)專業(yè)局領(lǐng)導(dǎo)： （蓋章） 年月日國(guó)際合作局的意見(jiàn)國(guó)際合作局領(lǐng)導(dǎo)： （蓋章） 年月日國(guó)際合作主管院領(lǐng)導(dǎo)意見(jiàn)主管院領(lǐng)導(dǎo)： 年月日

CHINESEACADEMYOFSCIENCES

APPLICATIONFORFELLOWSHIPFORYOUNG

INTERNATIONALSCIENTISTS1.NameinFullFamily First Middle2.Gender□Male□Female3.DateofBirthDDayMonthYear4.Nationality5.Citizenship6.PermanentResident7.CurrentAppointmentand/orStatusTitle:Division:Institution:8.AcademicDegree(Ph.D.)Type: DateObtained(orExpected)Field: / /Institute: Country: DayMonthYear9.HigherEducation(Startfromthelatestone)NameofUniversity/Institution Location Degree Field CompletionDate(Month/Year)10.PreviousEmployment(Startfromthelatestone)NameofInstitution Location Position From-to(Month/Year)11.AcademicAwards(Pleaseindicatetitle,yearandconferrer.)12.ResearchFieldandSpecialization13.NameofProposedHostResearcherandHostInstitutionHostResearcher:Title:Division:HostInstitution:ResearchThemeinCAS(upto100lettersincludingspacesandsymbols)ProposedTenureofCASYoungFellowshipFrom: / / to / / Total:DayMonthYear DayMonthYear MonthsResearchPlaninCAS:Pleaseincludeatleastthefollowingitems:PresentresearchrelevanttoproposedresearchplanPurposeofproposedresearchProposedPlanExpectedresultsandimpacts

19.LanguageAbility(5:excellent 1:poor)SpeakingReadingWritingHearingEnglish54321 54321 543215432154321 54321 543215432154321 54321 543215432154321 54321 5432154321Chinese54321 54321 5432154321PastStay(s)inCASPlace: Year: Purpose:Name(s)ofotherfellowship(s)forwhichyouarenowapplyingMailingAddress(Approximatelythreemonthsafterreceivinganapplication,CASwillsendoutfellowship-commencementdocuments,socareshouldbetakentoensurethattheaddresswillremainvalid.PleasecheckOfficeorHome;unlessotherwisestatedwewillsendthedocumentstoyourOffice.□Office: □Home:Tel:Tel:Fax:Fax:E-mail:E-mail:23.Willyoubeaccompaniedbyspouseand/oroffspring(s)?Ifso,pleaseindicatetheirnamesandrelationship.Name:Relationship:24.IfyouhavebeenpreviouslyawardedasaCASfellowshiporparticipatedinanotherCASresearchprogram,pleaseindicatethenameoftheprogramandtheperiodofyourparti