名/Given Name：

国籍

/Nationality

出生地点

/Place of Birth

出生日期

/Date of Birth

年月 日

/year /month /date

男 □Male

女 □Female

已婚□Married

未婚□Single

护照号码

/Passport No.

宗教/Religion

最后学历/Previous Education

现职业/Occupation

现工作单位/Current Employer   or Institute

永久通讯地址/Home Country   Mail Address (Permanent address):

电话/Tel: 传真/Fax: E-mail:

目前通讯地址/Current address   if different from above:

电话/Tel: 传真/Fax: E-mail:

申请学习时间

Intended Study Periods

从/from 年/Y 月/M 日/D 到/to年/Y 月/M 日/D

现有汉语水平/Check the appropriate box to   indicate the number of Chinese words you know ______

A None B about 800 C about 1500 D about 2500 E over 3500

汉语水平考试情况/Level of HSK Test:   ____________________________________

现有英语水平/English:□ 很好/Excellent □好/Good □较好/Fair  □差/Poor □不会/None

我的英语水平可以用英语学习/I can   be taught in English: □ 是/Yes  □否/No

其他语言/Other   Languages:___________________________________________________________________

申请人是否曾在华学习或任职/Have you ever studied or worked in China

□是/Yes:  学习或任职单位/Institution or Employer:   _________________________________________________

在华时间/Time in China:   自/From:年/Year_____月/Month _____至/To:年/Year_____月/Month _____

□*否/No:

学生类别/Program   Applied For：

1. Bachelor Degree Program in _

2. Master Degree Program in   ______

3. 非学历项目/Non-degree Program □A.汉语培训/General   Chinese Language Training

□B.课程进修/Special Courses

□C.单项短期研究课题/Short-term Research Projects

□D.访问学者/Visiting Scholars

申请人经费来源/Source of Financial Support:

□团体资助/Organization   :  资助团体名称/Sponsor Organization Name:________________________________

□家庭资助/Family   (sponsor’s name） :  ______________ □个人支付/Individual: ______________

推荐人情况/ Information for Referees

受教育情况/Education Background:

学校/Institutes 起止时间/ 专业/Fields of Study   / 毕业证书及学位证书/

Years attended(from/to)Certificates (to be) Obtained

工作经历/WorkingExperiences:

工作单位 起止时间 从事工作 职务及职称

Employer Time (from/to) Work Engaged Posts Held

家庭主要成员/Family   members:

姓名/ Name 关系/ Relation 电话和传真/ Tel. &   Fax

所附材料情况（请在所附附件前划‘X’标明）/Materials   Attached (Please Indicate with ‘X’in the Bracket.):

□两封推荐信(申请硕士或博士学位者需要)/Two Letters of   Recommendation (Only Necessary for Postgraduate or Doctoral).

□本人最后学历成绩单复印件（须公证）/Transcripts of   the Most Advanced Studies (Notarized Photocopy).

□本人最后学历证书复印件（须公证）/Diploma of Most   Advanced Studies (Notarized Photocopy)：

□本科/Bachelor’s □硕士/Master’s □博士/Doctor’s □ 其它/Others

□外国人体格检查记录复印件/ Photocopy of Foreigner   Physical Examination Form (Only Necessary for some countries).

□其它附件（请列出）/Other   Attachments (List Needed)：_________________________________________________________

注：每份申请材料最多不超过20页，请全部使用A4纸。

Each set of the complete materials should   not exceed 20 pages. Please use DIN A4.

无论申请人是否被录取，上述申请材料恕不退还。

Whether the   candidates are accepted or not, none of the application materials will be   returned.

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的、与本人来华学习身份不符合的活动；

During my stay in China, I shall abide   the laws and decrees of the Chinese government, and will not participate in any activities in

Chinawhich 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，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 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.

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 home country as   soon as I complete my scheduled program in China, and will not extend my stay   without valid

reasons.

学生本人签字/Signature of   the applicant

Date:

（无此签名，申请无效/The application   is invalid without the applicant’s signature）