《外国汉学研究学者访华计划申请表》

1、国家汉办/孔子学院总部HanBan/ Con fucius In stitute HeadquartersNo.129, Deshe ngme nwai Street, Xiche ng DistrictBeiji ng P.R. Chi na, 100088http:/www.ha nba 外国汉学研究学者访华计划申请表Application of Visiting Program for Foreign Scholars of Sinology to China请用中文或英文填写 Please complete the form in Chinese or English.1.

2、申请人情况 /Personal information :护照用名 /Passport name：姓 /Family n ame:名 /Give n n ame:国籍 /Nationality : 护照号码 /Passport No.: 出生日期 /Date of birth :年 /Year月 /Month 日 /Day出生地点 /Place of birth :国家 /Country : 城市 /City : 男 /Male 女/Female已婚 /Married 未婚 /Single 其他 /Other 第一语言 /First language： 宗教 /Religion : 通讯地址

3、/Present address： 2.受教育情况（填至申请日） 学校Institutions电话 /Tel: 传真 /Fax : E-mail : /Education background (to the time of application)所获证书Diploma/degree obtained在校期间主修专业From / toFields of study3.工作经历 /Employment Record工作单位起止时间EmployerFrom / to职务及职称Job Title4. 汉语水平(请填写：好、较好、一般)/ Chinese proficiency: (Please i

4、ndicate with excellent, good or fair )会话/Speaking： 阅读/Reading： 写作/Writing :5. 其他语言水平(请填写： 好、较好、一般)/ Proficiency in other languages: (Please indicate with excellent, good or fair)语言 /Language：会话 /Speaking：阅读 /Reading：写作 /Writing :语言 /Language：会话 /Speaking：阅读 /Reading：写作 /Writing :语言 /Language：会话 /Spe

5、aking：阅读 /Reading：写作 /Writing :/ Bibliography and6. 曾发表的主要学术论文、著作及作品，发表刊物名称、时间和内容摘要(可另附纸)abstracts of works published (A separate sheet may be used)7. 您曾几次访华？ /How many times have you visited China? 您最后一次来访的时间 /Time of your last visit: 当时访问的目的 /Purpose of the visit:当时曾访问过的机构 /In stituti ons visited:

6、 8. 您曾经在哪些国家/地区进行过汉学研究 (中文学习)？ / In which countries/regions have you been for China studies ( Chinese learning)?1.2. 3. 9. 本次访华希望访问的中国机构和学者/Institutions and scholars you want to visit during this program :机构 A/Institution A: 学者 /Scholar: 机构 B/Institution B: 学者 /Scholar: 机构 C/Institution C:学者 /Schola

7、r: 10. 是否申请往返国际旅费？/Do you intend to apply for international round-trip air ticket?是/Yes 否 /No 日期/Date如是，请说明希望如何安排行程始发地 /Departure/If yes, please suggest your itinerary:目的地/Arrival11. 本次访华研究内容概要 (可另附纸 )/Research plan in China for this program( A separate sheet may be used)：12所附材料情况(请在所附材料前标明X ) /Docu

8、ments attached (Please indicate with X in the bracket):发表过的著作或论文清单 /Bibliography and abstracts 短期来华研究访问计划 /Research plan in China知名学者推荐信 /Letters of recommendation by notable professors 中国机构或教授邀请函 /Invitation letter from Chinese institutions or professors. 其他(请列出) /Other attachments (list needed):13

9、. 亲属情况 /Family members of the applicant:年龄/Age职业 /Occupation姓名 /Name配偶 /Spouse: 父亲 /Father: 母亲 /Mother: 其他 /Other: 申请人声明 /I, the applicant, hereby certify that ：1) 本表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，遵守中国法律、法规，不从事任何危害社会秩序的、与本人来华研究学者身份不相符合

10、的活动；During my stay in China, I shall abide by the laws and decrees of the Chinese government, and will not engage in any activities which are deemed to be adverse to the social order and are inappropriate to the capacity as a research scholar.3) 如违反上述保证而受到中国法律、法规或校纪、校规的惩处，我愿意接受中国国家汉办的相应处罚。If I am judged by the Chinese laws, decrees, by the rules and regulations of Chinese institutions as having violated any of the above, I will not lodge any appeal against any penalty by NOCFL.申请人签字 /Signature of the Applicant ： 日期 /Date：14