I ………………………………填写姓名……………… apply for admission in ……………………………………………… (academic programme) offered in (language) for the academic year 20 20 autumn spring semester
PERSONAL DATA 数
Title 称呼
Mr Mrs Miss Ms
Surname family name 姓氏
Middle name 中间名字
First given names (underline the name you use) 名字
Mother’s maiden name (surname姓氏 middle name中间名字 first name(s)名字) 婚前姓
Gender 性
Male Female
Place of birth (city country) 出生
Date of birth (ddmmyyyy) 出生日期
Nationality 国籍
Country of residence 居住国
Passport number place of issue and
date of expiration (ddmmyyyy) 护号签发日期期日期
ADDRESS AND CONTACTS 址联系方式
Country 国家
City and post code 城市邮编
House number and street 门牌号街道
Mailing address (if different from the permanent address) 邮寄址(常住址)
Telephone mobile 电话手机
Fax 传真
Email 电子邮箱
Contacts of a family member in case of emergency (address telephone fax email)
紧急情况位家庭成员联系方式(址电话传真电子邮箱)
EDUCATION AND QUALIFICATIONS 教育背景相关资格
All schools attended examination records and degrees 学校考试记录学位情况
School name University name 学校名称学名称
Address 址
Country 国家
Post code 邮编
Telephone 电话
Fax 传真
Level of education 受教育程度
Type of certificate degree 证书类型学位类型
Identification number of certificate degree 证书编号学位编号
Date of certificate degree 证书签发日期学位授予日期
Please add tables as required 请根求添加表格
Please attach a copy of certificate(s)degree(s) 请附份证书学位证书复印件
FOREIGN LANGUAGE COMPETENCY 外语水
Language 语种
Exam type 考试类型
Level 级
1
2
3
Please attach a copy of certificate(s) 请附份外语水证书复印件
DECLARATION 声明
I 填写姓名 hereby declare that to the best of my knowledge the information given on this form is true complete and accurate and no requested information has been omitted
Signature 签名 Date
Notes and remarks of the applicant 申请附言意见
Signature Date
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