编号:中国辽宁省政府外国留学生奖学金申请表APPLICATIONFORMFORLIAONINGGOVERNMENTSCHOLARSHIP(年度)申请人姓名(中文):Name(英文):申请学习院校:填报日期年月日辽宁省教育厅制辽宁省教育厅SCHOLARSHIPCOUNCILLIAONINGPROVINCIALDEPARTMENTOFEDUCATION中国,辽宁省,沈阳市,皇姑区,崇山东路46-1号;Add:No.46-1chongshaneastroad,huanggudistrict,shenyangcity,liaoningprovince,P.R.China邮编postcode:110032电话Tel:0086-24-86896000;传真Fax:0086-24-86893002Http//:(Theabovetableisonlyfor)中国辽宁省政府外国留学生奖学金申请表APPLICATIONFORMFORLIAONINGGOVERNMENTSCHOLARSHIP请申请人认真阅读本表第四页的填表说明。请用中文或英文填写此表格。请用电脑打印或用蓝色或黑色钢笔认真书写表格内容,请在所选项框内划‘X’表示。不按规定填写的表格将视作无效。Pleasereadcarefullytheimportantnotesonthelastpagebeforefillingouttheform.PleasecompletetheforminChineseorEnglish.IftheformisnotfilledinonPC,pleasewritelegiblyinblackorblueink.Pleaseindicatewith‘X’intheblankchosen.Anyformsthatdonotfollowthenoteswillbeinvalid.1、申请人情况护照用名/PersonalInformation:姓/FamilyName:名/GivenName国籍/Nationality:护照号码/PassportNo.出生日期/DateofBirth:年/Year月/Month日/Day出生地点/PlaceofBirth:国家/Country:城市/City:男/Male□女/Female□已婚/Married□未婚/Single□其它/Other□母语/NativeLanguage:宗教/Religion:当前联系地址/PresentAddress:电话/Tel:传真/Fax:E-mail:永久通信地址/PermanentAddress:2、受教育情况/EducationBackground:学校在校时间主修专业毕业证书及学位证书InstitutionYearsAttended(from/to)FieldsofStudyCertificatesObtainedorToObtain照片Photo3、工作经历/EmploymentRecord:工作单位起止时间从事工作职务及职称EmployerTime(from/to)WorkEngagedPostsHeld4、语言能力/LanguageProficiency)a)汉语/Chinese:很好/Excellent□好/Good□较好/Fair□差/Poor□不会/None□HSK考试等级或其他类型汉语考试成绩/LevelofHSKtestorothercertificateswhichcanshowyourChineselevel:b)英语/English:很好/Excellent□好/Good□较好/Fair□差/Poor□不会/None□我的英语水平可以用英语学习/IcanbetaughtinEnglish:是/Yes□否/No□c)其他语言/OtherLanguages:5、来华学习计划/ProposedStudyinChina:a)博士研究生/Doctorgraduatestudent:□b)申请来华学习专业或研究专题/SubjectorFieldofStudyinChina:c)申请院校/PreferencesofInstitutionsofHigherEducationinChina:d)申请专业学习时间/DurationoftheMajorStudy:自/From:年/Year月/Month至/To:年/Year月/Mothe)是否需要补习汉语/DoYouNeedElementaryChineseStudypriortotheMajorStudy?是/Yes:□请填写申请汉语补习时间(不计在专业学习时间)/If‘Yes’,pleaseindurationthedurationofyourelementaryChinesestudy(notincludedinthelengthofthemajorstudy).否/No:□6、拟在华学习或研究的详细内容(可另附纸)/PleaseDescribetheDetailsofyourStudyorResearchPlaninChina(anextrapapercanbeattachedifthisnotenough):7、曾发表的主要学术论文、著作及作品/AcademicPapers,Writing&ArtWorksPublished:8、推荐您申请中国辽宁省政府奖学金的机构或个人/PleaseSpecifytheOrganizationorPersonRecommendingyouforthisScholarship:9、申请人在华事务联系人或机构/TheGuarantorChargingYourCaseinChina:名称/Name:电话/Tel:传真/Fax地址/Address:10、申请人是否曾在华学习或任职/HaveyoueverStudiedorWorkedinChina?是/Yes□学习或任职单位/InstitutionorEmployer在华时间/TimeinChina:自/From:年/Yeas月/Moth至/To:年/Year月/Moth否/No□11、申请人亲属情况/FamilyMemberoftheApplicants:姓名年龄职业NameAgeEmployment配偶/Spouse:父亲/Father:母亲/Mother:****************************************◆所附材料情况(请在所附附件前‘X’标明)/materialsattached(PleaseIndicatewith‘X’intheBracket.):□两封推荐信/TwoLetterofRecommendation.□有关中国辽宁省政府外国留学生奖学金申请表/Applicationforliaoninggovernmentscholarship□本人最后学历成绩单复印件(须公证)/TranscriptsoftheMostAdvancedstudies(Notarizedphotocopy)□本人最后学历证书复印件(须公证)/DiplomaoftheMostAdvancedStudied(Notarizedphotocopy)□本科/Bachelor’s硕士/Master’s博士/Doctor’s其它/Others□外国人体格检查记录(复印件)ForeignerphysicalExaminationFrom(photocopy)□来华学习计划/studyPlaninChina□所发表的文章等/ArticleorPaperswriterorpublished□其它附件(请列出)/OtherAttachments(Listtape):注:每份申请材料最多不超过20页,请全部用A4纸Eachsetofthecompletematerialsshouldnotexceed20pages.PleaseuseDINA4.无论申请人是否被录取,上述申请材料恕不退还。Whetherthecandidatesareacceptedornot,alltheapplicationmaterialswillnotbereturned.申请人保证/IHerebyAffirmThat:.1.申请表中所填写的内容和提供的材料真实无误:Allinformationandmaterialsgiveninthisformaretrueandcorrect2.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的、与本人来华学习身份不符合的活动;DuringmystayinChina,IshallabidebythelawsanddecreesoftheChinesegovernment,andwillnotparticipateinactivitiesinChinawhicharedeemedtobeadversetothesocialorderofChinaandareinappropriatetothecapacityasastudent.3.来华后服从辽宁省教育厅所安排的就读院校和学习专业,不得无故要求变更学校和所学专业;IwillagreetothearrangementofmyinstitutionandspecialtyofstudyinChinamadebyLiaoningProvincialDepartmentofEducation,andwillnotapplyforanychangesinthesetwofieldswithoutvalidreasons.4.在学期间,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;DuringmystudyinChina,Ishallabidetherulesandregulationsofthehostuniversity,andconcentrateonmystudyandresearches,andfollowtheteachingprogramsarrangedbytheuniversity.5.按照规定参加辽宁省政府奖学金年度评审;IwillgothroughtheproceduresoftheAnnualReviewofLiaoningProvincialGovernmentScholarshipasrequired.6.按规定期限修完学业,按期回国,不无故在华滞留;IshallreturntomyhomecountryassoonasIcompletemyscheduledprograminChina,andwillnotextendmystaywithoutvalidreasons.7.我保证,未同时接受其它任何渠道的奖学金或资助。IdeclarethatthisistheonlyScholarshipIamapplyingforatpresent.8.如违反上述保证而受到中国法律、法规或校纪、校规的惩处,我愿意接受辽宁省教育厅中止或取消奖学金及其它相应的处罚。IfIamjudgedbytheChineselawsanddecreesandtherulesandregulationsoftheuniversityashavingviolatedanyoftheabove,IwillnotlodgeanyappealagainstthedecisionofLingningProvincialDepartmentofEducationonsuspending,orwithdrawing,orotherpenalties.申请人签字/SignatureofApplicant:日期/Date:(无此签名,申请无效/Theapplicationisinvalidwithouttheapplicant’ssignature)填表说明(每一项数字与申请表中每一项序号相对应):GUIDELINESFORFILLINGINTHISFORM(NUMBERSREFERRINGTOTHEVARIOUSBLOCKS):1、本项所有内容申请