1. 申请人基本情况/Personal Information

   照  片/Photo

姓/Family Name:

名/Given Name:  

国籍/Nationality :

出生日期/Date of Birth :  

性别/Sex:  

护照号码/Passport No.:  

婚否/Married or Unmarried:  

2. 所在院校/University：

3 . 学生类别/Type of Student：

?   博士研究生/Doctoral Student     ? 硕士研究生/Master
Student  

?   本科生/Undergraduate

4．所学专业/Subject：  

5．永久通讯地址及联系方式/Permanent Address :  

6．当前联系地址/Present Address:  

7. 电话/Telephone No. :

8. 传真/Fax:     –

9.邮箱/Email:  

10. 教育背景/Education Background

学校/Institutions:                                                         

在校期间/Years Attended(From-to):                                         

主修专业/ Major of Study：                                                

毕业证书及学位证书/ Diploma or Degree Obtained or to Obtain：

11．工作经验/Employment
Record

工作单位/Employer:    –                                               

起止时间/Time (From –to) :    –                                         

从事工作/Work engaged:    –                                           

职务及职称/Posts and Titles Held:   –                                     

12．语言能力/Language
Proficiency

汉语/Chinese: :                                                         

英语/English:   –                                                      

其他语言/Other Languages:                                               

13.上一学年学习成绩单（另附纸）/Examination Grades of your Study for last term (academic
year) in University(attach paper)

14.申请人保证/I
hereby affirm that

（1）申请表中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，遵守中国的法律、法规，不从事任何危害中国社会秩序、与本人来华学习身份不符的活动。

During my study in China, I shall abide
the laws and decrees of the Chinese government, and will not participate in
any activities in China which are deemed to be adverse to the social order of
China and are inappropriate to the capacity as a student.

（3）在学期间服从学校安排，遵守学校的校纪校规，全力投入学习和研究工作，尊重学校的教学安排。

During my study in Guangdong, I will
agree to the arrangements of the host university, I shall abide by the rules
and regulations of the university, and concentrate on my studies and
researches, and follow the teaching programs arranged by the university. 

（4）按规定期限修完学业，按期回国，不无故在华滞留。

I shall return to my country as soon as I
complete my scheduled program in China, and will not extend my stay without
valid reasons.

（5）如违反上述保证而受到中国法律法规或校纪校规的惩处，我愿意接受取消或退还奖学金及其它相应的处罚。

If I am judged by the Chinese laws and
the decrees and the rules and regulations of the university as having
violated any of the above, I will not lodge any appeal against the decision,
or withdrawing my scholarship, or other penalties.

申请人签字/Signature of the Applicant:                       

日期/Date:                       

（以下由学校填写/University fills
up the following forms）

15. 学习主要课程及效果评价：（包括语言学习、专业课程、教学实习等， 请附成绩、论文、校内外表现情况等）（本页不够可加页）

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