中國政府獎學金申請表
中國政府獎學金申請表
CSC NO.
派遣途徑:
學生類別:
經(jīng)費辦法:
學習專業(yè):
安排院校:1. 2. 3.
中國國家留學基金管理委員會
CHINA SCHOLARSHIP COUNCIL
中國 北京復興門內大街160號 100031
No.160 Fuxingmennei Street, Beijing 100031, P.R.China
Tel: 0086-10-66413253 E-mail: laihua@csc.edu.cn
Fax:0086-10-66413255
(The above table is only for CSC)
中 國 政 府 獎 學 金 申 請 表
APPLICATION FORM FOR CHINESE GOVERNMENT SCHOLARSHIP
請申請人認真閱讀本表第四頁的填表說明。請用中文或英文填寫此表格。請用電腦打印或用藍色或黑色鋼筆認真書寫表格內容。請在所選項框內劃‘X’表示。不按規(guī)定填寫的表格將視作無效。
Please read carefully the important notes on the last page before filling out the form. Please complete the form in Chinese or English. If the form is not filled in on PC, please write legibly in black or blue ink. Please indicate with‘X’in the blank chosen. Any forms that do not follow the notes will be invalid.
1. 申請人情況/Personal Information:
護照用名/Passport Name: 姓/Family Name: ___________________________________________________ 名/Given Name: ____________________________________________________ 國籍/Nationality: ________________ 護照號碼/Passport No.: __________________ 出生日期/Date of Birth: 年/Year_______月/Month_______日/Day_______ 出生地點/Place of Birth: 國家/Country:_____________ 城市/City:_____________ 男/Male: □ 女/Female: □ 已婚/Married: □ 未婚/Single: □ 其它/Other: □ 母語/Native Language:_______________________ 宗教/Religion:______________________________________ 當前聯(lián)系地址/Present Address:___________________________________________________________________ 電話/Tel: _____________________ 傳真/Fax: _____________________ E-mail: ________________________ 永久通信地址/Permanent Address: _______________________________________________________________
2. 受教育情況/Education Background:
學校
Institutions
在校時間
Years Attended (from/to)
主修專業(yè)
Fields of Study
畢業(yè)證書及學位證書
Certificates Obtained or To Obtain ___________________ _____________________ _____________________ ______________________ ___________________ _____________________ _____________________ ______________________ ___________________ _____________________ _____________________ ______________________
3. 工作經(jīng)歷/Employment Record:
工作單位
Employer
起止時間
Time (from/to)
從事工作
Work Engaged
職務及職稱
Posts Held ___________________ _____________________ _____________________ ______________________ ___________________ _____________________ _____________________ ______________________ ___________________ _____________________ _____________________ ______________________
4. 語言能力/Language Proficiency: a).漢語/Chinese: 很好/Excellent □ 好/Good □ 較好/Fair □ 差/Poor □ 不會/None □ HSK 考試等級或其他類型漢語考試成績/ Level of HSK test or other certificates which can show your Chinese level:______________________________________________________________________________
b).英語/English: 很好/Excellent □ 好/Good □ 較好/Fair □ 差/Poor □ 不會/None □ 我的英語水平可以用英語學習/I can be taught in English: 是/Yes □ 否/No □
c).其他語言/Other Languages:___________________________________________________________________
5. 來華學習計劃/Proposed Study in China:
a).本科生/Bachelor's Degree Candidate: □ 碩士研究生/Master's Degree Candidate: □ 博士研究生/Doctor's Degree Candidate: □ 研究學者/Research Scholar: □ 漢語進修生/Chinese Language Student: □ 普通進修生/General Scholar: □ 高級進修生/Senior Scholar: □ b).申請來華學習專業(yè)或研究專題/Subject or Field of Study in China:____________________________________
c).申請院校/Preferences of Institutions of Higher Education in China: Ⅰ.________________________ Ⅱ. ________________________ Ⅲ._______________________
d).申請專業(yè)學習時間/Duration of the Major Study: 自/From:年/Year_________月/Month _________ 至/To:年/Year_________月/Month _________ e).是否需要補習漢語/Do You Need Elementary Chinese Study prior to the Major Study? 是/Yes: □ 請?zhí)顚懮暾垵h語補習時間(不計在專業(yè)學習時間內)/ If 'Yes', please indicate the duration of your elementary Chinese study(not included in the length of the major study). 自/From:年/Year_______月/Month ________ 至/To:年/Year________月/Month ________ 否/No: □
6. 擬在華學習或研究的詳細內容(可另附紙)/ Please Describe the Details of your Study or Research Plan in China (an extra paper can be attached if this space is not enough): ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________
7. 曾發(fā)表的主要學術論文、著作及作品/Academic Papers, Writing & Art Works Published: ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________
8. 申請獎學金類別/Scholarship Applied:
A. 全額獎學金/Full Scholarship: □
B. 部分獎學金/Partial Scholarship: 學費/Tuition: □ 住宿費/Accommodation: □ 醫(yī)療費/Medical Care: □ 教材費/Learning Materials: □
9. 推薦您申請中國政府獎學金的機構或個人/Please Specify the Organization or Person Recommending you for this Scholarship: _______________________________________________________________________________
10. 申請人在華事務聯(lián)系人或機構/The Guarantor Charging Your Case in China:
名稱/Name:_______________________________ 電話/Tel:_________________ 傳真/Fax:_________________
地址/Address:_________________________________________________________________________________
11. 申請人是否曾在華學習或任職/Have you ever Studied or Worked in China? 是/Yes: □ 學習或任職單位/Institution or Employer: _________________________________________________ 在華時間/Time in China: 自/From:年/Year_____月/Month _____至/To:年/Year_____月/Month _____ 否/No: □
12. 申請人親屬情況/Family Members of the Applicants: 姓 名 年 齡 職 業(yè) Name Age Employment
配偶/Spouse: __________________________ ______________ _____________________________
父親/Father : __________________________ ______________ _____________________________
母親/Mother: __________________________ ______________ _____________________________
* 所附材料情況(請在所附附件前劃‘X’標明)/Materials Attached (Please Indicate with ‘X’in the Bracket.):
□ 兩封推薦信/Two Letters of Recommendation.
□ 有關中國院校接受函或錄取通知書/Admission Letter or Admission Notice of Chinese Universities .
□ 本人最后學歷成績單復印件(須公證)/Transcripts of the Most Advanced Studies (Notarized Photocopy).
□ 本人最后學歷證書復印件(須公證)/Diploma of the Most Advanced Studies (Notarized Photocopy):
本科/Bachelor's □ 碩士/Master's □ 博士/Doctor's □ 其它/Others □
□ 外國人體格檢查記錄(復印件)/ Foreigner Physical Examination Form (Photocopy).
□ 來華學習計劃/ Study Plan in China.
□ 所發(fā)表的文章等/ Articles or Papers Written or Published.
□ 美術作品(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)(只限申請美術和音樂專業(yè)的申請人)/Examples of Art (6 color pictures) and Music (1 audio tape) Work (Only for the applicants applying for Fine Arts and Music).
□ 其它附件(請列出)/Other Attachments (List Needed):__________________________________________________________
注:每份申請材料最多不超過20頁,請全部使用A4紙。 Each set of the complete materials should not exceed 20 pages. Please use DIN A4. 無論申請人是否被錄取,上述申請材料恕不退還。 Whether the candidates are accepted or not, all the application materials will not be returned.
* 申請人保證/I Hereby Affirm That:
1. 申請表中所填寫的內容和提供的材料真實無誤; All information and materials given in this form are true and correct.
2. 在華期間,遵守中國的法律、法規(guī),,不從事任何危害中國社會秩序的、與本人來華學習身份不符合的活動;
During my stay in China, I shall abide by 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. 來華后服從CSC所安排的就讀院校和學習專業(yè),不得無故要求變更學校和所學專業(yè);
I will agree to the arrangements of my institution and specialty of study in China made by CSC, and will not apply for any changes in these two fields without valid reasons.
4. 在學期間,遵守學校的校紀、校規(guī),全力投入學習和研究工作。尊重學校的教學安排;
During my study in China, I shall abide the rules and regulations of the host university, and concentrate on my studies and researches, and follow the teaching programs arranged by the university.
5. 按照規(guī)定參加中國政府獎學金年度評審;
I shall go through the procedures of the Annual Review of Chinese Government Scholarship Status as required.
6. 按規(guī)定期限修完學業(yè),按期回國,不無故在華滯留;
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.
7. 如違反上述保證而受到中國法律、法規(guī)或校紀、校規(guī)的懲處,我愿意接受中國國家留學基金管理委員會中止或取消獎學金及其它相應的處罰。
If I am judged by the Chinese laws and decrees and the rules and regulations of the university as having violated any of the above, I will not lodge any appeal against the decision of CSC on suspending, or withdrawing my scholarship, or other penalties.
申請人簽字/Signature of the Applicant:______________________________ 日期/Date:___________
(無此簽名,申請無效/The application is invalid without the applicant's signature)
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