1. 申请人基本情况/Personal Information

照 片/Photo

姓/Family Name:

名/Given Name:

国籍/Nationality

出生日期/Date of Birth

性别/Sex:

护照号码/Passport No.:

婚否/Married or Unmarried：

2. 申请院校/University：

3.在粤学习计划/Proposed Study in Guangdong：

a.申请学习类别/Student Category

□ 博士研究生/Doctoral Student □ 硕士研究生/Master Student

□ 本科生/Undergraduate

b.申请学习专业/Major of Study:

c.申请入学日期/Enrollment of Time: 年（Yr.） 月（Mon.）

4．永久通讯地址及联系方式/Permanent Address：

5．当前联系地址/Present Address:

6. 电话/Telephone No. :

8. 传真/Fax:

7.邮箱/Email:

8. 教育背景/Education Background

学校/Institutions:

在校期间/Years Attended(From-to):

主修专业/ Major of Study：

毕业证书及学位证书/ Diploma or Degree Obtained or to Obtain：

9．工作经验/Employment Record

工作单位/Employer:

起止时间/Time (From –to) :

从事工作/Work engaged:

职务及职称/Posts and Titles Held:

10．语言能力/Language Proficiency

汉语/Chinese: :

英语/English:

其他语言/Other Languages:

11.经毕业学校确认的学习成绩单（另附纸）/ The Transcript Certified by former School or University (attach paper)

12.HSK的成绩单（根据录取高校的要求提供，另附纸）/Transcript for HSK(Applied University or College decides whether it should be provide, attach paper)

13. 申请来粤接受本科学历教育，应当提供所毕业高级中学的校长和一名教师的推荐信；攻读硕士、博士学位者应当提交至少两名教授或副教授的推荐信，曾发表的主要学术论文、著作及作品（另附纸）Principal and a teacher’s Rcomendation Letters’ should be Provided if applying for Undergraduate Programes;No Less than 2 professor s’ Recommendation Letters’ should be Provided if Applying for Master or Doctor’s Degree (attach paper)

14. 来粤学习和研究计划（本页不够可加页）/Studying and Research Plan(Stuck Paper is acceptable)

15.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 form are true and correct.

（2）在华期间，遵守中国的法律、法规，不从事任何危害中国社会秩序、与本人来华学习身份不符的活动。

During my study 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）在学期间服从学校安排，遵守学校的校纪校规，全力投入学习和研究工作，尊重学校的教学安排。

During my study in Guangdong, I will agree to the arrangements of the host university, I shall abide by the rules and regulations of the university, and concentrate on my studies and researches, and follow the teaching programs arranged by the university.

（4）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 country as soon as I complete my scheduled program in China, and will not extend my stay without valid reasons.

（5）如违反上述保证而受到中国法律法规或校纪校规的惩处，我愿意接受取消或退还奖学金及其它相应的处罚。

If I am judged by the Chinese laws and the 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, or withdrawing my scholarship, or other penalties.

申请人签字/Signature of the Applicant:

日期/Date:

拟

就

读

学

校

初

评

意

见

（以下由学校填写/University fills up the following forms）

负责人： 签字（盖章）

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