山东大学EMBA正式报名表.doc

本文档由中国EMBA在线搜集整理如需要了解山东大学EMBA项目信息，欢迎访问山东大学EMBA介绍网站/sdu_emba.shtml 报名须知一、为了使您的报名有效，请在截止日期之前提交所需材料。我们郑重承诺将对您的个人信息严格保密。提交的材料应包括：1报名表报名表需由本人认真填写所有栏目，务必工整书写。您的报名表将被学校留档，请您自行复印留底。2. 学历证明请提交所有学历、学位证书复印件及大学成绩单复印件（加盖教务部门公章）各两份。3. 两封推荐信推荐人必须充分了解申请人的个人情况、教育背景和工作业绩。推荐人之一建议由申请人的直接领导担任，另一位可以是同业中的权威人士。推荐信必须由推荐人本人用所附空白推荐表填写，否则推荐无效。4. 其他附件八张一寸近照（请在背面署名），其中三张按要求贴在报名表和资格审查表上。请在报名表规定处贴一张名片，并在报名表内附一张名片。请在报名表规定处贴上清晰的身份证复印件。二、 报名截止日期请参见当期招生简章。在收到申请人的报名表后，我们将进行初审，以确定参加笔试、面试的人选。请申请人在寄回报名表后注意查收考试通知。三、申请人声明 本人郑重声明我提供的所有个人信息皆准确和完整，我同意在需要的情况下提交原件以确认我的报名资格。报考程序规定的个人论述及自命题论文均由我本人完成。由于报名材料中的虚假、错误信息或重大遗漏而导致不被录取或取消学籍，后果由我个人承担。我理解并同意山东大学关于所有EMBA申请人报名材料归学校所有、不予退回的规定。申请人签名: 日期： . Please finish all the information required in the application form before the deadline, which should be treated as strictly confidential.1. Application FormPlease fill in every item in neat letter and save a copy before you send the application form back.2. Clear copy of college degree or diploma certificateTwo clear copies of college degree or diploma certificate and the copy of sealed official college transcript are necessary.3. Two Recommendation LettersPlease submit two letters of recommendation written by individuals who have observed your abilities and personalities in a professional or academic environment. One of them should be your current immediate supervisor. The other must be an authoritative figure in the same industry who knows the applicant well. The letters of recommendation are valid only when they are written and signed by the recommenders themselves.4. Others Five 1-inch recent photos bearing the name of the applicant on the back, with three pasted on the form as required.Please paste one business card on the form and enclose another one in it.Please paste one clear copy of your ID card. The deadline for application can be found in recruitment booklet. Candidates who have passed the preliminary checkup are to be interviewed. Please be noted to check our advice after application form had been mailed. Declaration Declaration by applicant：I hereby declare that all the information given in this application, including required attachments and supporting documents, is to the best of my knowledge, truthful, accurate and complete; and I agree to provide original documents/certificate(s) for verification when required. I further certify that all essays are entirely and exclusively my own work and that no documents have been falsified. I am aware that any misrepresentation or omission of material in my application will result in the denial of application or the cancellation of student status.I understand that materials received by Shandong University in connection with this application become the property of Shandong University, as such, no materials submitted can be returned. Signature： Date： Shandong University EMBA Program山东大学高级管理人员工商管理硕士请贴一寸彩色近照Please attachone 1-inchrecent photo请贴一张名片（反面）Please attach one business card(back)请贴一张名片（正面）Please attach one business card(front)请贴上清晰的有效身份证件复印件Please attach a clear copy of your ID card个人信息 Personal Data1.姓 名: 英文名（如果有） Name English name 2.性 别： 男 女 民族: 政治面貌: Gender Male Female Ethnic Group Party 3.出生日期: Date of Birth (dd/mm/yy) 身份证号(或护照号等)： Personal ID Number4.婚姻状况: 未婚 已婚Marital Status: Single Married5.国籍: 籍贯（或出生地）: Nationality Place of Birth 6.通讯信息 Contact Information 通讯地址： 省 市 邮编 Contact Address Province City Zip code 电话： 传真： 电子邮件： 手机： Telephone Fax E-Mail Mobile 常住地址： 省 市 邮编 Permanent Address Province City Zip code 电话： 传真： 电子邮件： 手机： Telephone Fax E-Mail Mobile 紧急联系人 In case of emergency, please contact: 姓名： (先生/女士)电话: 手机: Name (Sir/Madam)Tel Mobile7.家庭信息Family Information家庭成员Family Member关系Relationship工作单位Current Employer职务Position联系方式（手机）Contact Number工作经历 Work Experience1.全职工经验： 年 零 月 管理工作经验： 年 零 月Full-time Work Experience Years Month Management Experience Years Month2.目前工作单位： Current Employer 职 务： 担任此职务年限： 年 零 月Position Length of time at the current position 单位或集团员工人数： 直接下属员工人数： Number of employees in the company or organization Number of people under your immediate supervision 公司总资产： 万元（人民币） 年度销售额： 万元（人民币）Total assets of the current business Yuan (RMB) Total sales of the current business Yuan(RMB)是否为上市公司： 深圳 上海 香港 海外 否Listed company Shenzhen Shanghai Hong Kong Abroad No上市代码： Stock Code 请绘制目前所在单位的组织结构图 Please draw a chart describing your companys organizational structure.3.具体工作经历： （从最近的开始）Work Experience （starting from the most recent）单 位 名 称Company时 间(年/月)Date性 质*Category行 业*Industry年销售额Annual Sales职 务Position从From至To填写“性质”和“行业”时，请参考以下代码：Please refer to the following code for the items of Category and Industry单位性质代码: Which ownership category does your current business belong to?政府/事业单位 国有或国有控股 民营企业或私人控股Government State owned Private owned外资企业（请注明外方所属国别 /地区） 其 它 Foreign Invested (Please specify country/region) Others行业性质代码: Which industry are you working in now?加工制造业 咨询业 制药业 商品贸易/产品代理 Manufacturing Consulting Pharmaceuticals Trade/Commerce 公用事业 房地产/建筑业 金融/保险业 邮电通信业 Public Administration Real Estate/Construction Finance/Insurance Tele/Information交通运输/后勤、物流业 教育、体育、卫生 信息技术 传媒/文化Transportation/logistics Education/Sports/Hygiene IT Media/Culture饭店/旅游 其它 Hotel/Travel Others4.专业特长：Specialties请自我评价您在以下领域的能力和知识，这一信息将会有助于分组学习:Please evaluate yourself in following areas, this information will be helpful to form study group.弱一般强弱一般强WeakAverageStrongWeakAverageStrong财务会计Finance/Accounting信息技术Information Technology市场销售Marketing/Sales项目管理Project Management金融投资Financial Investment供应链管理Supply Chain Management生产运营Operation办公软件技能Office software skill组织行为Organization Behavior定量分析技能Quantity analytical skill 受教育状况 Education Profile所获学位或学历（请从高中开始填写）Please list the names of the institutions you have attended starting from the high school.校 名Name of Institution学校所在地Location时间 (年/月)Dates of Attendance专 业Degree学 位Degree获 得日 期(年/月/日)Date从(From)至(To)所受其它培训 TrainingsPlease list the trainings you have attended.课程名称Course Name培训机构Training Organization时间(年/月) Date成 绩Grade从 From至To所获证书 Certification请列出您所获得的职称证书、专业技术资格证书等信息（从最重要的开始）Please provide the information regarding the professional certifications you may have in the order of their importance to you.证书名称Certification颁发机构Issuer有效期（月/年月/年）Effective Period (mm/yyyy-mm/mmmm)荣誉和奖励 Honors and Awards请列出您获得的奖励、奖学金、荣誉以及其他成就（包括专利和著作）（从最重要的开始）。Please list below, in their order of importance to you, awards, scholarships, honors, and other achievements (including patents and publications).证书名称Certification颁发机构Issuer获得时间（月/年）Issue Date（mm/yyyy）社团活动 Social Activities请列出您参加过的主要学术、社会和专业方面的社团活动（从最重要的开始）Please list below, in their order of importance to you, significant educational, community, or professional activities in which you have participated.社团活动Social Activity担任职务Position开始时间（月/年）Date of Participation (mm/yyyy)简要介绍Brief Description业余爱好 Hobbies and Interests为了方便我们组织课余活动，请提供您的业余生活信息：To assist us in organizing extra-curriculum activities, please provide the following information about your hobbies.项 目Activities参与频率（次/月）Participating Frequency (times/month)喜爱程度排序Ranking高尔夫球 Golf保龄球 Bowling网 球 Tennis羽毛球 Badminton乒乓球 Table Tennis篮 球 Basketball 排 球 volleyball足 球 Football登 山 Mountain Climbing游 泳 Swimming音乐会 Concert国标舞 Ballroom Dancing棋 牌 Chess/Card-playing其 他Others ( )推荐人情况 Recommender Information请提供两位推荐人的个人信息，其中一位可以是您的直接领导，另一位是了解您的权威人士Please provide information about two individuals from whom you have requested letters of recommendation. One of them would be your immediate supervisor while the other must be an authoritative figure who knows you well. 姓 名Name性别Gender工 作 单 位Work Place职 务Position电 话Tel直接领导Immediate supervisor其他推荐人Other Recommender申请者调查 Applicant Survey请认真回答以下信息（您的回答仅做统计之用，并不会影响对您的考评）Please fill out the Applicant Survey below1. 您是从哪个渠道了解山东大学管理学院EMBA项目的？ (可多选)Where did you learn about EMBA Program of Shandong University?媒体 Media报纸 杂志 网站 Newspaper Magazine Website中国经营报 中国企业家 新浪 21世纪经济报道 . 财经 搜狐 经济观察报 哈佛商业评论 网易 参考消息 其他，请注明 山东大学EMBA网站其他，请注明 其他，请注明 山东大学EMBA的各类直邮资料DM from Shandong University EMBA Program邮寄材料 电子邮件本公司人力资源部 联系人及电话： HR department of my company同事/朋友 介绍人： 单位： Colleague or Friend Name Employer 电话： 手机： Tel Mobile 山东大学EMBA项目招生推广活动 请注明活动举办的地区： Information Session of Shandong University EMBA Program Please write the name of the city you attend其他，请注明： Others 2. 您是否申请过山东大学EMBA项目? 是 否 Have you applied for the Shandong University EMBA? Yes No如果是，请问您是哪年申请的？ 申请时间： If yes, when did you apply for the Program? Apply Time 3. 项目您是否同时也申请其他院校的EMBA项目？ 是 否Have you applied for the other EMBA Program? Yes No如果是，请填写您申请的EMBA项目： If yes, what Program do you apply? 个人论述 Essays1. 以下论述题是为了让我们对您的学术水平、工作能力、事业目标及抱负等有进一步的了解，也是录取工作的重要环节，请对每个问题做认真考虑后回答。请注意您的答案没有对错之分，请给予详细并富有创意的答案以突显您的与众不同。This section is very important as it helps us evaluate your academic and professional credentials, goals and aspirations etc. Please note there are no right or wrong answers, your answer should be as specific and creative as possible in highlighting what distinguishes you from other applicants.a. 简要描述您所在单位的基本情况，以及您的工作职责。 Please brief the basic background of your organization and your major responsibilities. b. 请简单介绍您的职业生涯中取得的主要成就，您所遇到的最具挑战性的管理难题是什么？您是如何解决它的？Please brief your major accomplishments in your career experience. What is the most challenging managerial problem that you have faced and how did you solve it? c. 介绍您本人的性格特征。 您认为自己有哪些突出的强项和弱项？您认为作为一个成功的企业家需要具备哪些基本素质？ Please brief the feature of your character. What do you think are your major strengths and weaknesses? In your opinion, what kind of basic credentials should a successful entrepreneur possess?d. 您是如何定义“成功”的？ 您认为自己取得“成功”了吗？您是否还拥有更高的人生目标？请与我们分享。 How do you define success? Do you think you have got “success”? Have you any higher goal? Please share with us. e. 您如何看待商业规则和道德准则？ 请与我们分享您曾经遭遇的挑战或困惑，您是如何解决的？How do you think of business rule and ethical standard? Please describe an ethical dilemma that you have faced and how it was resolved. f. 请说明您攻读EMBA的主要目的？ Please brief the main purpose of taking part in EMBA program and your career plan. 推 荐 信此信请申请人的直接领导填写推荐人须知：山东大学EMBA项目旨在培养富于竞争意识和创新精神的国际化商业领袖。我们要求申请人至少有十年以上的工作经验和六年以上的管理经验。推荐人的意见和权威性是我们选择学员的重要参考。学员必须征得单位同意每月占用两天工作时间参加学习，校方同时建议各单位给予学员必要的财务支持。申请人姓名： 您认识申请人多长时间：从 到 1. 申请人现在的工作职责是什么？ 2. 您认为被推荐人最突出的特点和优点是什么？ 还有哪些地方需要提高？ 3. 您认为EMBA教育对申请人有哪些帮助？其个人的职业发展前景如何？ 4. 为全面正确评估申请人，您还有何意见可供我们参考？ 5. 请就下表所列各项对申请人作评估 项目优秀良好一般较差无法判断分析能力判断力人际交往/团队合作沟通能力领导潜能创新思维6. 请给出您对被推荐人的总体评价： 极力推荐 推荐 有保留的推荐请贴一张名片Please attach one business card推荐人信息 您是否是山东大学的学生或者校友？ 不是 是 在您的工作时间，我们可否就申请人情况与您联系？ 不可以 可以 签 名： 日 期： 如您需要更多信息，请联系：山东大学EMBA教育中心 电话：Tel：0531-88361007 地址：济南市山大南路27号网