东北大学秦皇岛分校外国留学生学习申请表

东北大学秦皇岛分校外国留学生学习申请表APPLICATION FORMFOR FOREIGNERSWISHING TOSTUDY INNORTHEASTERN UNIVERSITYAT QINHUANGDAO地址育交流中心电话066004/Tel:86-,传真AddressInternational Educationand ExchangeCenter/Fax:86-电子邮件Northeastern Universityat Qinhuangdao/E・mail:Qinhuangdao,Hebei,China,066004护照用名

1./Full legalname________________________________________________________________________姓/SURNAME名/FIRST MIDDLE中文姓名中文姓名没有贝！不填

2./Chinese name_______________1leave blankif notapplied姓/SURNAME名/FIRST国籍护照号码

3./Country ofcitizenship

4./Passport No.性别口男□女婚姻状况宗教信仰

5./Gender/Male/Female

6./Marital status7,/religious belief出生日期年/月/日出生地点

8./Date ofbirthy/m/d

9./Place ofbirth州/省/STATE/PROVINCE,国家/COUNTRY永久通讯地址在国外的永久地址

10./Permanent homeaddress permanent address outsideChina传真/FAX电话/TELEPHONE电子邮件/E-MAIL目前通讯地址

11./Current mailingaddress ifdifferent frompermanentaddress传真/FAX电话/TELEPHONE电子邮件/E-MAIL如果在中国填中国地址/电话Fill inthe address/tel in China ifyou arein China学习专业或研究课题请参见招生专业目录来华留学申请类别

12.

13./Categories offoreign students□本科生硕Field ofstudy,please referto theCatalog ofPrograms/Undergraduate student□士研究生语言

2./Masters candidate□生/交

3.Chinese Languagestudent□流生/

4.Exchange student学习期限

14./Duration ofStudy自至/from/to本人学历从中开始

15.IWJ/Educational BackgroundStarting fromhigh school校名/Name地点/Location专业/Major时间/Dates attended所获学位/Degree Awarded本人工作经历从当前工作开始

16./Work ExperienceStarting fromcurrent position工作单位/Employer地点/Location时间/Dates attended职位/Position接下页/Continue onthe nextpage语言能力用优、良、可

17./Language ProficiencyExcellent,good,or fair语言/language读/reading写/writing说/speaking中文/Chinese英语/English曾发表的作品和论文

18./Publications andtheses特长爱好

19./Special skillsor interest在华学习或研究的详细计划，请另附页

20.Statement ofyour studyor researchin NortheasternUniversity,using aseparate sheet.

21.经济保证人姓名/Financial Sponsorsname填爸爸或妈妈的信息Info rfone ofyour parents地址及电话号码/AddressTel____________________________________________________________________________________________与申请人关系/Relationship withthe Applicant保证人签名/Sponsors Signature

22.在华事务联系人或机构/Person oragency toact onyour behalfin China上也址及电话号码/AddressTel___________另一个在中国的亲戚或朋友Another personinChina

23.派遣方或推荐人意见/Comment ofsponsor orrecommending party友好学校交流或朋友、中介介绍的才填，自己报名的不填Only fillin thissection ifyou areintroduced bya friend/aiency oryou areae exchangestudent frompartner university签名/S ignature日期/Date申请人保证上述情况真实无误/I herebyaffirm

1.I havereviewed theabove information,and itis trueand completeto the在中国学习期间遵守中国政府的法律和学校的规章制度best ofmy knowledge.

2.I shallabide bythe lawsof theChinesegovernment andthe regulationsof theUniversity.申请人签字日期/Signature/Date。