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外国专家信息表ForeignExpertsInformationForm专家类别：□经技类□文教类workingfield：EconomicsandTechnologyCulturalandEducation姓（如护照所示）：SURNAME(AsinPassport)名（如护照所示）：FIRSTANDMIDDLENAME(AsinPassport)其它曾用姓氏（外文）：OTHERSURNAMEUSED(Maiden,Religious,Professional,Aliases)其它名字（外文）：OTHERFIRSTANDMIDDLENAMESUSED出生年月日：国籍：护照号码：DATEOFBIRTH(yy-mm-dd)NATIONALITYPASSPORTNUMBER译名：性别:□男□女CHINESENAMESEXMALEFEMALE出生地（外文）：国家省份城市PLACEOFBIRTH(Country-State-/Province-City)是否已婚：□是□否Marrige:yesno住址(国家、省、市、街道、单元号码、邮编,外文填写)：HOMEADDRESSINCOUNTRYOFORIGIN(IncludeapartmentNumber,street,city,stateorprovince,postalcode,andcountry)住址电话：电子信箱地址：HOMETELEPHONENUMBERE-MAILADDRESS最高学历：EDUCATIONBACKGROUND现工作单位CURRENTWORKUNIT聘用单位名称、地址：_______________________________________________________DONOTWRITEINTHISSPACE37*37PHOTOGluephotohere请勿填写此处2寸免冠照片请用胶水将照片附于此处NAMEANDSTREETADDRESSOFEMPLOYERINCHINA(Postalboxnumberunacceptable)专家国内地址AddressinChinaNAMEANDSTREETADDRESSOFEMPLOYERINCHINATELEPHONEANDFAXNUMBERANDCONTACTPERSON(Postalboxnumberunacceptable)在中国拟聘职务：POSITIONINCHINA在中国拟承担任务：YOURWORKINGMISSIONSINCHINA拟抵中国时间：WHENWILLYOUARRIVEINCHINA?预计停留时间：HOWLONGDOYOUINTENTTOSTAYINCHINA?拟前往申请Z签证的国家或地区WhereareyougoingtoapplyforyourZvisa？列出所有曾经授予你护照的国家：LISTALLCOUNTRESTHATHAVEEVERISSUEDYOUAPASSPORT你是否曾经在中国工作过？□是□否HAVEYOUEVERWORKEDINCHINA?YesNo何时?何地?WHENWHERE你是否曾经申请过外国专家来华工作许可？□是□否HAVEYOUEVERAPPLIEDANYOTHERFOREIGNEXPERTSWORKINGPERMITINCHINAYesNo何时?何地?WHENWHERE证件代办人签名：电话：028-85407455随行家庭成员情况ACCOMPANYINGFAMILYMEMBER123姓名（如护照所示）NAME姓SURNAME名FIRSTANDMIDDLENAME与申请人关系RELATIONSHIPTOTHEAPPLICANT国籍NATIONALITY护照号码PASSPORTNUMBER(聘用单位签章)年月日