复旦大学外国留学生入学申请表.doc

复旦大学外国留学生入学申请表Application Form for Foreigners Wishing to Study at Fudan University该栏由学校填写/This is to be filled out by the university.类别专业汉语费用申请编号请申请人用中文或英文印刷体认真填写以下诸项，字迹要清楚。不能缺项填写，没有的请写“无”。Please fill in the form in standard Chinese or English carefully and clearly. Please write None if not applicable. 护照名（英语）Full Name with Middle Initialin English according your passport照片PHOTO中文名Chinese Name必须填写，不超过6个汉字。 This has to be filled in no more than six characters.国籍Country of citizenship性别Gender 男 Male 女 Female出生日期Date of birth年/yy 月/mm 日/dd出生地点Place of birth护照号码Passport No.护照有效期Valid until年/yy 月/mm 日/dd婚姻状况Marital Status宗教信仰Religion职业Occupation工作单位Employer手机Cell phone电子邮件E-mail家庭住址Home Address邮政编码Zip Code电话/传真Tel/Fax通信地址Mailing address收件人Receiver邮政编码Zip Code电话/传真Tel/Fax推荐单位Recommended by联系人Contact person联系地址Address电话/传真Tel/Fax学习经历（高中起填写） Educational background（From High School）学校名称Institutions在校时间Years attended (from/to)主修专业Field of study所获文凭Diploma received语言能力，请用“好，一般，不会”评价。 Language proficiency（Good/Average/None）汉语Chinese HSK：_级 ; 新HSK (初级、中级、高级)： _ ; BCT：_英语EnglishTOEFL(score)_； GMAT_； GRE_； IELTS_其他Other学习计划 Study Plan at Fudan (please click what you plan to study)申请类别Category专业或专题 Subject or field of study指导教师Advisor学位生DEGREE 博士研究生Doctoral candidate专业/Major：研究方向Research field：欲完成的论文题目Topic of your planned thesis： 硕士研究生Master candidate专业/Major：研究方向Research field： 本科生Undergraduate志愿Choice 1： 志愿Choice 2：考试地点： 上海/Shanghai 北京/Beijing 首尔/Seoul Place of test： 东京/Tokyo 新加坡/Singapore 吉隆坡/Kuala Lumpur是否服从调剂/Accept other majors or not?： 是/Yes 否/No是否读汉语言（对外）专业？Will you choose Chinese language undergraduate program (to foreigners)? 是/Yes 否/No非学位生NONDEGREE 高级进修生Senior Advanced Student专业Major： 研究学者Research Scholar研究专题 Research Topic： 普通进修生General Advanced Student专业Major： 语言进修生Language student汉语/Chinese language学习时间 Duration of study自/From 年/yy 月/mm 日/dd至/To年/yy 月/mm 日/dd经费来源 Financial Support 自费Self-support保证人姓名Guarantors name：与申请人关系Relationship with the applicant：地址Address： 电话/传真 Tel/fax：保证人签名Guarantors signature ： 校际交换University exchange学校名称University name： 联系人Contact person： 工作部门Department：地址Address：电话/传真Tel & Fax： E-mail： 系际交换Department exchange学校名称University name： 院系名称 Department name：地址Address： 联系人Contact person:电话/传真Tel/Fax: E-mail： 奖学金Scholarship奖学金名称Scholarship name：提供奖学金单位Provided by: 电话/传真Tel/Fax： E-mail：申请人保证/I hereby affirm that: 1)上述各项中所填写的内容和提供的材料真实无误； All information and materials provided here are true and correct. 2)在华期间，遵守中国的法律和法规，不从事任何危害中国社会秩序的，与本人来华学习身份不相符合的活动；During my stay in China, I shall abide by the laws and decrees of the Chinese government, and will not participate in any activities which are deemed to be adverse to the social order in China and are inappropriate to the capacity as a student; 3)在学期间，遵守学校的校纪校规，尊重学校的教学安排。 During my study in China, I shall observe the rules and regulations of the university, and will concentrate on my studies and researches, and will follow the teaching programs provided by the university. 申请人签