贵州师范大学国际学生奖学金申请表 (Application Form for International Student Scholarship at Guizhou Normal University )

贵州师范大学国际学生奖学金申请表

Application Form for International Student Scholarship

at Guizhou Normal University

请申请人认真用中文或英文填写此表格。

Please fill this form in Chinese or English conscientiously.

1. 申请人情况/Personal information：

  护照用名/Name in passport：

  姓/Family name: _______________________________（BLOCK LETTERS）

  名/Given name: ________________________________（BLOCK LETTERS）

 中文姓名/Chinese Name: ________________________

  国籍/Nationality：______________     护照号码/Passport No.：____________

  出生日期/Date of birth：______  年/Year______月/Month  _____日/Day

  出生地点/Place of birth：国家/Country：__________   城市/City：________   

  男/Male□  女/Female□        已婚/Married□  未婚/Single□   其它/Other□

是否华裔/Are you ethnic Chinese?          是/Yes□         否/No□

  最后学历/Education level：___________       宗教Religion：_________________

目前所在学校或机构/Place of study or work：___________________________________________________________

  联系地址/Current address：____________________________________________________________________________       

电话/Tel： ___________________  手机/Mobile :_____________________  邮箱/E-mail:_________________________

2. 受教育情况/Education background：

               学校                             在校时间                       专业               

      Institutions                                             From / to                                 Fields of study

   _________________________            _________________________                                _________________________    

   _________________________           _________________________              _________________________    

            ________________________          _________________________              _________________________                                               

3.汉语能力/Chinese Language Proficiency   

很好/Excellent □     好/Good □       较好/Fair □     差/poor □     不会/None □

 HSK等级 /Level of HSK Test:______________________________  

4.申请学习计划/Proposed Study in China:

a. 预科生/Foundation Candidate □       本科生/Bachelor’s Degree Candidate □      硕士研究生/Master’s Degree Candidate □       

博士研究生/PHD Candidate □          

语言生/Chinese Language Learning Candidate □

b.申请专业/Subject of Study in China:_____________________________  

c.申请学习时间/Duration of the Major Study

 自/From:  /年/Year_______ 月/Month_____/To:年/Year_____ 月/Month _____

d.申请奖学金类型/Type of Application   

全额奖学金/ Full Financial Assistance  □

全免学费+免住宿费/Full Tuition Wavier + Free Accommodation  □

半免学费+免住宿费/Half Tuition Wavier + Free Accommodation  □

5. 推荐人或推荐单位/ Referee or recommending organization

推荐人姓名或推荐单位/Name of Referee:

电话/Tel:_____________   推荐人或单位负责人签字/Signature of the Referee: ___     ____    日期/Date：__    _____   

6.学校评定意见（注：申请者本人不用填写）

申请人保证/ I Hereby Affirm That：

l 本表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 accurate.

l 在华期间，遵守中国法律、法规，不从事任何危害社会秩序的、与本人来华学习身份不相符合的活动；During my stay in China, I shall abide by the laws and decrees of China, and will not participate in any activities which are deemed to be adverse to the social order and are inappropriate to my capacity as a student.

l 如违反上述保证而受到中国法律、法规或校纪、校规的惩处，我愿意接受培训学校中止或取消奖学金及其他相应处罚。If I am judged by the Chinese laws as having violated any of the above, I will not lodge any appeal against the decision of training institution on suspending, or withdrawing my scholarship, or any other penalties.

申请人签字/Signature of the Applicant： ________________________ 日期/Date：____________