長(zhǎng)城獎(jiǎng)學(xué)金申請(qǐng)表

PAGE1CSCNO.派遣途徑：學(xué)生類別：經(jīng)費(fèi)辦法：學(xué)習(xí)專業(yè)：安排院校：1.2.3.中國(guó)國(guó)家留學(xué)基金管理委員會(huì)CHINASCHOLARSHIPCOUNCIL中國(guó)北京車公莊大街9號(hào)A3-13100044No.9A3-13chegongzhuangStreet,BeijingP.R.China100044,Tel:0086-10-66093900E-mail:laihua@Fax:0086-10-66093915Http://（TheabovetableisonlyforCSC）中國(guó)政府長(zhǎng)城獎(jiǎng)學(xué)金申請(qǐng)表APPLICATIONFORMFORCHINA/UNESCO-THEGREATWALLFELLOWSHIP請(qǐng)申請(qǐng)人認(rèn)真閱讀本表第四頁(yè)的填表說明。請(qǐng)用中文或英文填寫此表格。請(qǐng)用電腦打印或用藍(lán)色或黑色鋼筆認(rèn)真書寫表格內(nèi)容。請(qǐng)?jiān)谒x項(xiàng)框內(nèi)劃‘X’表示。不按規(guī)定填寫的表格將視作無效。Pleasereadcarefullytheimportantnotesonthelastpagebeforefillingouttheform.PleasecompletetheforminChineseorEnglish.IftheformisnotfilledinonPC,pleasewritelegiblyinblackorblueink.Pleaseindicatewith‘X’intheblankchosen.Anyformsthatdonotfollowthenoteswillbeinvalid.照片照片Photo申請(qǐng)人情況/PersonalInformation:護(hù)照用名/PassportName:姓/FamilyName:___________________________________________________名/GivenName:____________________________________________________國(guó)籍/Nationality:________________護(hù)照號(hào)碼/PassportNo.:__________________出生日期/DateofBirth:年/Year_______月/Month_______日/Day_______出生地點(diǎn)/PlaceofBirth:國(guó)家/Country:_____________城市/City:_____________男/Male：□女/Female：□已婚/Married：□未婚/Single：□其它/Other：□母語/NativeLanguage:_______________________宗教/Religion:______________________________________當(dāng)前聯(lián)系地址/PresentAddress:___________________________________________________________________電話/Tel:_____________________傳真/Fax:_____________________E-mail:________________________永久通信地址/PermanentAddress:_______________________________________________________________受教育情況/EducationBackground:學(xué)校Institutions在校時(shí)間YearsAttended(from/to)主修專業(yè)FieldsofStudy畢業(yè)證書及學(xué)位證書CertificatesObtainedorToObtain_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________工作經(jīng)歷/EmploymentRecord:工作單位Employer起止時(shí)間Time(from/to)從事工作WorkEngaged職務(wù)及職稱PostsHeld______________________________________________________________________________________________________________________________________________________________________語言能力/LanguageProficiency:a).漢語/Chinese:很好/Excellent：□好/Good：□較好/Fair：□差/Poor：□不會(huì)/None：□HSK考試等級(jí)或其他類型漢語考試成績(jī)/LevelofHSKtestorothercertificateswhichcanshowyourChineselevel:______________________________________________________________________________b).英語/English:很好/Excellent：□好/Good：□較好/Fair：□差/Poor：□不會(huì)/None：□我的英語水平可以用英語學(xué)習(xí)/IcanbetaughtinEnglish:是/Yes□否/No□c).其他語言/OtherLanguages:___________________________________________________________________來華學(xué)習(xí)計(jì)劃/ProposedStudyinChina:a).本科生/Bachelor’sDegreeCandidate：□碩士研究生/Master’sDegreeCandidate：□博士研究生/Doctor’sDegreeCandidate：□漢語進(jìn)修生/ChineseLanguageStudent：□普通進(jìn)修生/GeneralScholar：□高級(jí)進(jìn)修生/SeniorScholar：□PAGE1b).申請(qǐng)來華學(xué)習(xí)專業(yè)或研究專題/SubjectorFieldofStudyinChina:____________________________________c).申請(qǐng)?jiān)盒?PreferencesofInstitutionsofHigherEducationinChina:Ⅰ.________________________Ⅱ.________________________Ⅲ._______________________d).申請(qǐng)專業(yè)學(xué)習(xí)時(shí)間/DurationoftheMajorStudy:自/From：年/Year_________月/Month_________至/To：年/Year_________月/Month_________e).是否需要補(bǔ)習(xí)漢語/DoYouNeedElementaryChineseStudypriortotheMajorStudy?是/Yes：□請(qǐng)?zhí)顚懮暾?qǐng)漢語補(bǔ)習(xí)時(shí)間（不計(jì)在專業(yè)學(xué)習(xí)時(shí)間內(nèi)）/If‘Yes’,pleaseindicatethedurationofyourelementaryChinesestudy(notincludedinthelengthofthemajorstudy).自/From：年/Year_______月/Month________至/To：年/Year________月/Month________否/No:：□擬在華學(xué)習(xí)或研究的詳細(xì)內(nèi)容（可另附紙）/PleaseDescribetheDetailsofyourStudyorResearchPlaninChina(anextrapapercanbeattachedifthisspaceisnotenough):__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________曾發(fā)表的主要學(xué)術(shù)論文、著作及作品/AcademicPapers,Writing&ArtWorksPublished:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________申請(qǐng)獎(jiǎng)學(xué)金類別/ScholarshipApplied:全額獎(jiǎng)學(xué)金/FullScholarship:□部分獎(jiǎng)學(xué)金/PartialScholarship:學(xué)費(fèi)/Tuition:□住宿費(fèi)/Accommodation:□醫(yī)療費(fèi)/MedicalCare:□教材費(fèi)/LearningMaterials:□推薦您申請(qǐng)中國(guó)政府獎(jiǎng)學(xué)金的機(jī)構(gòu)或個(gè)人/PleaseSpecifytheOrganizationorPersonRecommendingyouforthisScholarship:_______________________________________________________________________________申請(qǐng)人在華事務(wù)聯(lián)系人或機(jī)構(gòu)/TheGuarantorChargingYourCaseinChina:名稱/Name:_______________________________電話/Tel:_________________傳真/Fax:_________________地址/Address:_________________________________________________________________________________申請(qǐng)人是否曾在華學(xué)習(xí)或任職/HaveyoueverStudiedorWorkedinChina?是/Yes:□學(xué)習(xí)或任職單位/InstitutionorEmployer:_________________________________________________在華時(shí)間/TimeinChina:自/From:年/Year_____月/Month_____至/To:年/Year_____月/Month____否/No:□申請(qǐng)人親屬情況/FamilyMembersoftheApplicants:姓名年齡職業(yè)NameAgeEmployment配偶/Spouse:_____________________________________________________________________父親/Father:_____________________________________________________________________母親/Mother:_____________________________________________________________________﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡﹡所附材料情況（請(qǐng)?jiān)谒礁郊皠潯甔’標(biāo)明）/MaterialsAttached(PleaseIndicatewith‘X’intheBracket.):□申請(qǐng)表（一式兩份）/TwoLettersofRecommendation.□兩封推薦信/TwoLettersofRecommendation.□有關(guān)中國(guó)院校接受函或錄取通知書/AdmissionLetterorAdmissionNoticeofChineseUniversities.□本人最后學(xué)歷成績(jī)單復(fù)印件（須公證，一式兩份）/TranscriptsoftheMostAdvancedStudies(NotarizedPhotocopy).□本人最后學(xué)歷證書復(fù)印件（須公證，一式兩份）/DiplomaoftheMostAdvancedStudies(NotarizedPhotocopy)：本科/Bachelor’s□碩士/Master’s□博士/Doctor’s□其它/Others□□外國(guó)人體格檢查記錄（復(fù)印件）/ForeignerPhysicalExaminationForm(Photocopy).□來華學(xué)習(xí)計(jì)劃/StudyPlaninChina.□所發(fā)表的文章等/ArticlesorPapersWrittenorPublished.□美術(shù)作品（本人作品彩照六張）、音樂作品（本人音樂作品盒式錄音帶一盤）（只限申請(qǐng)美術(shù)和音樂專業(yè)的申請(qǐng)人）/ExamplesofArt(6colorpictures)andMusic(1audiotape)Work(OnlyfortheapplicantsapplyingforFineArtsandMusic).□其它附件（請(qǐng)列出）/OtherAttachments(ListNeeded)：__________________________________________________________注：每份申請(qǐng)材料最多不超過20頁(yè)，請(qǐng)全部使用A4紙。Eachsetofthecompletematerialsshouldnotexceed20pages.PleaseuseDINA4.無論申請(qǐng)人是否被錄取，上述申請(qǐng)材料恕不退還。Whetherthecandidatesareacceptedornot,alltheapplicationmaterialswillnotbereturned.申請(qǐng)人保證/IHerebyAffirmThat:申請(qǐng)表中所填寫的內(nèi)容和提供的材料真實(shí)無誤；Allinformationandmaterialsgiveninthisformaretrueandcorrect.在華期間，遵守中國(guó)的法律、法規(guī)，不從事任何危害中國(guó)社會(huì)秩序的、與本人來華學(xué)習(xí)身份不符合的活動(dòng)；DuringmystayinChina,IshallabidebythelawsanddecreesoftheChinesegovernment,andwillnotparticipateinanyactivitiesinChinawhicharedeemedtobeadversetothesocialorderofChinaandareinappropriatetothecapacityasastudent.來華后服從CSC所安排的就讀院校和學(xué)習(xí)專業(yè)，不得無故要求變更學(xué)校和所學(xué)專業(yè)；IwillagreetothearrangementsofmyinstitutionandspecialtyofstudyinChinamadebyCSC,andwillnotapplyforanychangesinthesetwofieldswithoutvalidreasons.在學(xué)期間，遵守學(xué)校的校紀(jì)、校規(guī)，全力投入學(xué)習(xí)和研究工作。尊重學(xué)校的教學(xué)安排；DuringmystudyinChina,Ishallabidetherulesandregulationsofthehostuniversity,andconcentrateonmystudiesandresearches,andfollowtheteachingprogramsarrangedbytheuniversity.按照規(guī)定參加中國(guó)政府獎(jiǎng)學(xué)金年度評(píng)審；IshallgothroughtheproceduresoftheAnnualReviewofChineseGovernmentScholarshipStatusasrequired.按規(guī)定期限修完學(xué)業(yè)，按期回國(guó)，不無故在華滯留；IshallreturntomyhomecountryassoonasIcompletemyscheduledprograminChina,andwillnotextendmystaywithoutvalidreasons.如違反上述保證而受到中國(guó)法律、法規(guī)或校紀(jì)、校規(guī)的懲處，我愿意接受中國(guó)國(guó)家留學(xué)基金管理委員會(huì)中止或取消獎(jiǎng)學(xué)金及其它相應(yīng)的處罰。IfIamjudgedbytheChineselawsanddecreesandtherulesandregulationsoftheuniversityashavingviolatedanyoftheabove,IwillnotlodgeanyappealagainstthedecisionofCSConsuspending,orwithdrawingmyscholarship,orotherpenalties.申請(qǐng)人簽字/SignatureoftheApplicant:____________________________日期/Date:___________（無此簽名，申請(qǐng)無效/Theapplicationisinvalidwithouttheapplicant’ssignature）填表說明（每一項(xiàng)數(shù)字與申請(qǐng)表中每一項(xiàng)序號(hào)相對(duì)應(yīng)）：填表說明（每一項(xiàng)數(shù)字與申請(qǐng)表中每一項(xiàng)序號(hào)相對(duì)應(yīng)）：GUIDELINESFORFILLINGINTHISFORM(NUMBERSREFERRINGTOTHEVARIOUSBLOCKS):本項(xiàng)所有內(nèi)容申請(qǐng)人必須如實(shí)填寫。Personalinformationabouttheapplicantmustbefilledintrulyandcorrectly.請(qǐng)列出申請(qǐng)人已經(jīng)完成或即將完成的各級(jí)教育，包括中學(xué)、職業(yè)教育及高等教育各項(xiàng)。請(qǐng)隨材料附上經(jīng)公證的最高級(jí)教育的學(xué)歷證明、畢業(yè)證書或?qū)W位證書的原件復(fù)印件和英文翻譯件（均一式兩份）。Pleaseprovidethefollowinginformationforallcompletedsecondary,vocational,technical,undergraduateorpostgraduatetrainingandqualifications.Anyincompletecoursesshouldalsobelisted.OnenotarizedcopyofyourofficialtranscriptscertificatesandnotarizedcopiesofEnglishtranslationsofyourhighesteducationmustbeincludedwitheachapplicationform.請(qǐng)列出申請(qǐng)人曾經(jīng)從事和現(xiàn)在從事的工作。Pleaseclarifyyourworkexperiencesandyoucurrentpost.本項(xiàng)將表明申請(qǐng)人的語言情況，對(duì)申請(qǐng)人來華后的課程安排及授課語言非常重要。請(qǐng)隨材料附上有關(guān)證明材料。Pleasestateyourknowledgeoflanguages,especiallyChineseandEnglish.Ifyouhavepassedalanguagetest,pleaseincludeacopyoftheresultsinyourapplicationmaterials.ThisisveryimportantbecauseitwilldecideyourteachinglanguageinChina.請(qǐng)申請(qǐng)人按本項(xiàng)提示選擇來華后的學(xué)習(xí)計(jì)劃，CSC有權(quán)作相應(yīng)調(diào)整。TheapplicantwillchoosethedetailedinformationconcerninghisstudyinChinaaccordingtothecluesgiveninthiscell.CSCisentitledtomakeanynecessaryadjustmentaccordingtotheapplicant’spreferences.請(qǐng)選擇你申請(qǐng)來華學(xué)習(xí)的類別。PleasechoosewhatlevelofstudyyouwanttobeengagedininChina.請(qǐng)?jiān)敿?xì)寫出你申請(qǐng)來華學(xué)習(xí)的專業(yè)或從事研究的專題。PleasespecifyyoursubjectorfieldofstudyinChina.請(qǐng)從接受中國(guó)政府獎(jiǎng)學(xué)金留學(xué)生的高等學(xué)校中選擇三所并填寫在本欄中，你的選擇僅作為CSC安排學(xué)校時(shí)的參考。如果你已經(jīng)被某所中國(guó)高校錄取，請(qǐng)附上該校的《錄取通知書》或接受函的復(fù)印件。PleasechoosethreepreferencesofChineseinstitutionsamongtheChineseuniversitieswhichcanacceptedChineseGovernmentScholarshipstudentsandlistthemintheblankshere.ThefinalarrangementofinstitutionissubjecttotheadjustmentofCSCwithyourchoicesasreferences.IfyouhavebeenacceptedbyaChineseuniversity,pleaseattachthecopyoftheiradmissionnoticetoyourapplicationmaterials.請(qǐng)標(biāo)明你所申請(qǐng)的來華學(xué)習(xí)時(shí)間。DurationofthemajorstudyappliedinChina.由于中國(guó)高校的主要授課語言為漢語，所以來華后的漢語補(bǔ)習(xí)非常重要。請(qǐng)?jiān)谠擁?xiàng)標(biāo)明你是否需要漢語補(bǔ)習(xí)及所希望的漢語補(bǔ)習(xí)時(shí)間。SincetheteachinglanguageofChineseuniversiti