中文姓名Chinese Name if any

性别Gender

婚姻状况Marital Status

出生日期Date of Birth

年(Y) 月(M) 日(D)

出生地Country of Birth

国籍Nationality

护照号码Passport No

护照有效期Passport Valid Until

年(Y) 月(M) 日(D)

电子邮件E-mail Address

联系电话Telephone

就读目的Study Purpose

□学历本科生Bachelor Degree Earning student

申请奖项Applying for

□一等奖First-class Academic Excellence scholarship

□二等奖Second-classAcademic Excellencescholarship

就读目的Study Purpose

□学历专科生Higher Vocational Education student

申请奖项Applying for

□学历专科生奖学金Academic Excellence scholarship

备注

lThose who have an excellent grade or above in the moral evaluation of the academic year and have passed HSK level 5are qualified forthefirst-classscholarship.

lThose who have a good moral evaluation grade or above in the academic year and have passed HSK level 4 are qualified for thesecond-classscholarship.

入学时间Enrolledor will be enrolledin

年(Y) 月(M)

就读专业Major or Program

学生证号ZIMEIDif any

学分绩点GPA

语言成绩EnglishProficiency

□native

□second/foreign language with a test score or proof attached

请申请人将以下所有申请材料以一个PDF文档电子提交：

To apply please submitElectronicallyin ONE PDF file:

a.申请表Application form

b.个人陈述Personal Statement (including applying reason, study plan and career plan, etc.)

c.简历Resume (including education background, awards and specialty)

d.护照复印件Copy of Passport

e.最高学位证书Certificate of the highest degree

f.成绩单Academic transcript

g.语言水平证明Language Proficiency Certificate

h.两封推荐信（其中一封须由毕业院校教师出具）

i.Two Recommendation Letters (one should be issued by a teacher from the last graduating school)

j.健康证明Health Certificate

k.无犯罪记录证明No Criminal Record Certificate

l.其他佐证材料Other supporting documents

申请人保证：I hereby affirm that:

上述各项中所提供的情况是真实无误的；

All the information given in this form is true and correct.

在中国学习期间将遵守中国政府的法律和学校的规章制度。

I shall abide by the laws of the government of P.R. China and the regulations of the University

申请人签字： 日期：

Applicant’s signature: Date: