长城奖学金申请表.docx
中国国家留学基金管理委员会CHINASCHO1.ARSHIPCOUNCI1.中Ea北京年公立大物9号A*13100044No.9A313chcogzhangStreet.BcijingPRChinMOoO44、Te1.:O(JK61(卜660939(10E-mai1.:HihgFgCO$¢6"106609S915H11p,www.csc.cduxnCSCNO.派遣途径：学生奥别：经费办法:学习专业：安拌度校：1.2.3.(Theatn>vctab1.eison1.yforCSC)中国政府长城奖学金申请表APP1.ICATIONFORMFORchinajnesco-thegreatwa1.1.fe1.1.owship请申请人执兵闵诙本式第旧页的填表说,明.请用中文我英文填写比&格.靖用电标打卬或用黄色或，.色纲Z认算方耳茨格内g.在所逡M机内刈-X-表示。不按规定填芍的表格将视作七效.P1.CaSCrc<icarefu1.1.ytheimportant11o<csontheIaNtpagebc1.<xeIiIIinXoutIhcform.P1.caycomp1.etethe1.<rminChincwOrEnj1.ish.Iftheformisxfi1.1.edinonPC.p1.easewrite1.egib1.yinb1.ackorHueink.P1.easeindicatewith,X'intheb1.ankchosen.AnyfbmsIhatdonotfo1.1.owthenote%wi1.1.beinva1.id.申请人/Persona1.Infomuition:护yJf1.名，PaSSPortName:姓/Fami1.yName:名/GivenName:国/Nationa1.ity:护度号码/PassportNo.:出生日期/Da1.eofBir1.h:年，Year月/Mn1.h曰/Day出生地点/P1.aceofBin忙S/Country:城市/Ci1.y:男，Mak：¼,Fema1.e：d-,Ma11,ied:未将Sing1.e:其它Qhen母语JNa1.iVC1.anguage:宗Re!igion:当前疆系地址/PreseniAddress:电话/Te1.:A/Fax:E-mai1.:永久通信地址/PermanentAddress:受it情况，EdUCa1.ionBackground:学校在纥时间InstitutionsYearsAttended(from(0)主修专业Fie1.dsofStudy毕业证朽及学徒证书CertificatesObtainedorToObtain3.工作经历，EmPIcymemRecord:工作单位起止时刈Emp1.oyer,11mc(from*to)从事工作WorkEngaged军务及职救PostsHe1.d4. 海旨能力，1.anS1.I1.igCProficiency:哈汉由ChinCSC:很坳EXCMem：if/Good:较好/Rdr:Poor:不会，NOnc：HSK考试曾级或其他臭型汉语考试成绩，1.eve1.ofHSK<e$torothercertificateswhichcanshowyourChinese1.eve1.:b).英语，EngJiSh:很好/Exce1.1.ent:好，Good:较好/Fair:A.,P(x>r:不会小Ionu我的英语水平可以用英语学习CdnbCIaUgh1.inEngJish:YesS/NoC).其他语言/Other1.anguages:5. 来华学习计!/ProposedStudyinChina:*本科生JBachdcr'sDcgnxCandida1.c:汉语遗传生,Chinese1.anguageSuidcm:硕士研究生，MaS1.e/SDegieeCandidaie:普通送修生,Generu1.Scho1.ar：博士研究生/Doctor'sDegreeCandidate:高级选传生/SeniorScho1.ar:b)申请来华学习专业或研究专题/SubjectorFie1.dofStudyinChina:C).申请院校/PreferencesofInstiiuiionsofHigherEducationinChina:I.II.III.d),中请专业学习时刈/DuraMonoftheMajorStudy:/From:-.'Ycar月/Month至/To:4Ycar月/Monthe),是否寄雯补习汉语，DoYouNeedE1.ene11ar>,ChineseStudyprioroIheMajorStudy?是，Yes:O请填写申请汉语补习时间(不计在专业学习时河内)/IfftYes,.p1.easeindicatethedurationofyoure1.ementaryChineSestudy(notinc1.udedinthe1.engthofhemajorsdy).From:庠Ycar月/Month至/Tb:年/Year月/Month否/No:6. 拟在华学习或研£的详细内容(可另附执)/P1.cascDescribetheDetai1.sofyourStudyorResearchP1.aninChiru1.(anextrapapercanbe抵IaChCdifIhisspaceisnotenough):7. 曾发表的上美学术论文、著作及作品/AcademicPapers,Writing&ArtWorksPub1.ished:8. 中请奖学金类方力SChoIarShiPApp1.ied:A.全赖奖学金牛UHScho1.arship:B.郃分奖学金/Partia1.Scho1.arship:学费JTUNiOr<ifif.rAccommodahonzD医疗为McdiMCarcrD教材也T心mingMatcria1.szD9. 推荐您申请中国政府奖学公的机构戌.个人JPkascSpecifytheOianizationorPersonRecommendingyoufor(hisScho1.arship:10. 申请人在华事务茯系人或机构/TheGuarantorChargingYourCaseinChina:名称/Nme:电话11:Fax:地址7Address:11. 申请人是否*在华学习或,任我/HaveyoueverStudiedOrWorkedinChina?是As:口学习或任取单位JInS1.iUHionorEmp1.oyer:在华时间MmCinChina:自/From:年，Ygr月/'Month至/Tb:年/Year月/MonthSNor12. 申请人亲属情况Fnmi1.yMembersoftheApp1.icants:姓名年龄职业NameAgeEmp1.oyment史佃/Spouse:父/Father:母亲,Mother: 所部材料情况(青在所府府件划"X'#9!)/Materia1.srttached(P1.easeIndicatewith4X,intheBracketJ:中请表一式丙伶)Two1.x1.tc11iofRcconmcfxb1.ir>n.三i-ft4ttwoIx1.tenofRecommendation.有关中国俄救4i交岛或录取送知1.etterorAdmissionNoticeofChineseUnivcniiiics.本人被后竽历成结单复印件发公证ranscrip<softheMomAdvancedStudies(NotarizedPhotocopy).卡人找后学历迂书R印件(须公证.一式两份/DipiomaoHbeM<MAihnnedS1.udiexNomi比dPhMgPyk本科,'Bache1.orK口"上,'M;IMerM口tfJr.'Doc1.or口并它NXber口外国人体格怜会记录复卬件),ForeignerPhysica1.ExaminationForni(Pho4x>py1.来华学习计M/StudyP1.aninChina.所发表的文*学，A11>c1.corPapersWriiicnorPub1.ished.改家作品本人作品彩”六张工音乐作尤(盘人音乐作品盒式隶音帝一女)(H限中访美术外音乐令业的市访人1.EuimP1.gofArt(6co1.orpictures)ikIMusk<1audiotape)Work(On1.yf<wthe叩PiiaIMSapp1.yingforFineArtsandMusic).其它附外诂列出)NXbtfrAItairhmenU(1.is1.Needed):金玲中诗材料我多不超过20页，诂全部使用A4版Eachyofthecomp1.ete2CriKkhou1.dnMexceed20PafCtP1.cAyHCDIN4.无论中诗人是否欲录取，上爆中请材轩彩不退还。WhCtbCnbCMHididaicsarcaccepted<wncM.ni1.theapp1.icationmateria1.、wi1.1.no<bere1.umed. *诂人4H1.IHerebyAfTirm'1.hat:1. 申请机中所填耳的内容和提供的材林A实无谡：A1.1.infrn>a1.i(M)andna<e11akgienin1.hif<natrueandCCKTeC1.2. 在华期回，遗守中国的小搏、出境.不从事任何危杏中国社会稹序的、与本人臬华学,身伶不符合的活动：DuringInys1.ayinChina.1sha1.1.abidebyIhC1.awsanddeerwsofI1.wChiiwse)vern11n(.andwi1.1.nutpaticipa!einanyactvi1.ieinChinaWhicharedeemediobeadvesctoIbCsocia1.orderofChinaandarcinappropriate(othecapacityasastudent.3. 朱华后服从CSC所安加的就紫臣桢和学习令业,不徉£故去水文史学校和所学书士：Iwi1.1.agetotheaangcmcncsofmys(itut>onandspecia1.tyofMixiyinChinamadebyCSC.andwi1.1.immapp1.yforanychangesinthesetwofie1.dswithoutva1.idreasons.4. 在中期傅，遑中华做的权纪、权规，全力投入学力和研义工作尊文学校的放学安持：DuringmystudyinChina.Isha1.1.abideberu1.esandrcguU1.insofthehastuniversity,andccnccntraiconmystudiesandresearches,1111<1.fo1.1.
