WUHAN UNIVERSITY OF TECHNOLOGY
外国留学生来华学习申请表
Application Form for Foreigners Wishing to Study in China ﹡由申请人用中文、英文填写（请用印刷体）
﹡To be completed by the applicant in Chinese, English only (please write clearly )
1、姓： 名： Family Name: Given Name: 2、国 籍： 3、出生日期： Nationality: Date of Birth: Y M D 4、出生地： 5、性别： □ Male Place of Birth: Gender □ Female 6、宗教信仰： 7、婚姻状况： □ Single Religion: Marital status: □ Married 照 片 Photo 8、永久通讯地址： 9、护照号码： Permanent address: Passport No.: 10、电子邮箱: 11、电话号码： E-mail Address: Tel No.: 11、最后学历Latest Degree or Certificate： 学校Institution： 主修专业Major： 学习时间Years Attend：From yy mm To yy mm 所获证书、学位Diploma： □高中High School □本科Bachelor Degree □硕士Master Degree □博士Doctoral Degree 12、留学类别Indicate the nature of the program you wish to undertake 1）学历生/ Degree Program: □本科生B.A/ B.Sc. □硕士研究生M.A./ M.Sc. □博士研究生Ph.D. 2）非学历生/ Non-degree Program: □语言生Language Stu. □普通进修生Advanced Stu. □高级进修生Senior Stu. 13、来华学习 / 研究计划Describe your study / research plan to be undertake in China： 1）学习/研究专业Field of study / research： 2）汉语补习期限Duration of Chinese Language Class： From yy mm To yy mm 3）学习/研究期限Duration of study or research： From yy mm To yy mm 4）授课语言 Teaching Language： □ English □ Chinese 注：请务必交验中、英、法文的学历证书和成绩单复印件。 Note: Copies of last degree and transcripts in Chinese, English or French must be submitted. 14、经费来源 Source of financial support (Please tick) □本人支付Full Own Fund Or In Part □本国有关单位资助Funded By Home-Country Organization 15、在华事务联系人或推荐人的姓名、电话号码及电子邮箱： Name and telephone number of your reference or recommender in China to be notified in case of emergency. Name: Telephone No.: E-mails Address:
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16、语言熟练程度Language proficiency： 汉语Chinese：□Excellent □Good □Fair 英语 English：□Excellent □Good □Fair 其他 Other： □Excellent □Good □Fair 17、请附上由指导过你的副或正教授（或学校校长、系主任）出具有两封推荐信。请列出他们的姓名、职务/职称和地址Please submit two recommendation Letters written by associate professors or professors (school principal or department head) under whom you have studied, please List their names, positions / titles and addresses. 1）姓名Name: 职务/职称 Position of title: 地址Address: 2）姓名Name: 职务/职称 Position of title: 地址Address:
18、工作简历Work experience: 工作单位Employer：
职务/职称Position or Title： 工作期限Years Attend： From yy mm To yy mm 申请人保证： 1、上述各项所提供的情况是真实无误的； All the information given in this form is true and correct; 2、在中国学习期间将遵守中国政府的法律和学校的规章制度。 I shall abide by the laws of the Chinese Government and the regulations of the school. 日期： 申请人签名： Date: Y M D Signature: 注意：不完整的表或未按要求交验有关材料，将会延误对此申请的审理时间。 Important: An incomplete form, or the supporting documents not submitted, WILL DELAY the process of your application. （此表可复印The copy can be valid） ﹡请将申请人护照信息页复印件、最后学历复印件、最后学历成绩单等材料附后。 ﹡Please attach copies of applicant’s passport personal information page, latest degree certificate and transcripts of latest degree and other materials and documents at the back of this form. - 2 -
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