1、 外国人来华工作许可申请表 APPLICATION FORM FOR FOREIGNERS WORK PERMIT 外国人工作许可证号CURRENT WORK PERMIT NUMBER 姓（如护照所示）SURNAME (As in Passport) 名（如护照所示） FIRST AND MIDDLE NAMES (As in Passport) 照片 PHOTO 其他曾用姓氏（英文）OTHER SURNAME USED 其他曾用名字（英文）OTHER FIRST AND MIDDLE NAMES USED 中文姓名 CHINESE NAME 性别 GENDER 出生日期 DATE OF B
2、IRTH(yyyy-mm-dd) 婚姻状况 MARITAL STATUS 国籍 NATIONALITY 出生地 PLACE OF BIRTH(country) 护照类型 PASSPORT TYPE 护照号码 PASSPORT NUMBER 护照签发日期ISSUANCE DATE 护照有效期至 EXPIRATION DATE(yyyy-mm-dd) 最高学位 HIGHEST ACADEMIC DEGREE 汉语水平 CHINESE PROFICIENCY 是否掌握其他语言PROFICIENCY OF OTHER LANGUAGE 是否持有境外职业资格证书 HAVE YOU EVER OBTAIN
3、ED ANY PROFESSIONAL QUALIFICATION CERTIFICATE ABROAD? 职业资格证书名称和编号 NAME AND NUMBER OF PROFESSIONAL QUALIFICATION CERTIFICATES 申请人 电子邮箱 E-MAIL ADDRESS 列出所有曾授予你护照的国家 LIST ALL COUNTRIES THAT EVER ISSUED YOU A PASSPORT 列出所有曾使用过的护照号码 LIST ALL PASSPORT NUMBERS THAT YOU EVER HAVE USED 与任职相关工作经验RELATED WORKI
4、NG EXPERIENCE AND LENGTH OF WORKING TIME 聘用合同 /任职证明在华工作起始时间 INTENTED WORKING TIME IN CHINA 申请在中国工作职务 INTENTED JOB TITLE IN CHINA 工作岗位（职业） OCCUPATION 聘用方式 EMPLOYMENT METHOD 所属行业 INDUSTRY CATEGORY 薪酬 SALARY(monthly) 申请在华工作时间INTENTED WORKING TIME IN CHINA 每年在华工作时间（月 )WORKING TIME IN CHINA PER YEAR(mont
5、hs) 是否毕业于世界知名大学IF YOU ARE GRADUATED FROM WORLD RENOWNED UNIVERSITIES 是否需要行业主管部门批准 HAVE YOU OBTAINED APPROVAL FROM RELATED CHINESE INDUSTRY AUTHORITY? 行业主管部门名称NAME OF INDUSTRY AUTHORITY 行业主管部门批准证书文号 APPROVAL DOCUMENT NUMBER 是否持有中国职业资格证书（准入类） HAVE YOU EVER OBTAINED ANY CHINESE PROFESSIONAL QUALIFICATI
6、ON CERTIFICATE (for industry access)? 职业资格证书（准入类）名称 NAME OF CHINESE PROFESSIONAL QUALIFICATION CERTIFICATES(for industry access) 职业资格证书号码NUMBER OF CHINESE PROFESSIONAL QUALIFICATION CERTIFICATESOBTAINED (for industry access) 是否曾在世界 500 强企业、知 名金融机构或律师 在上述单位曾担任最高职务 HIGHEST POSITION 是否入选中国国内相关人才计划 IF Y
7、OU ARE 事务所等任职 DO YOU HAVE ANY EXPERIENCE IN WORLD TOP 500 COMPANIES,WELL-KNOWN FINANCIAL INSTITUTIONS OR LAWFIRMS? YOU HAVE EVER HELD IN AFOREMENTIONED ORGANIZATIONS SELECTED AS A CANDIDATE OF ANY CHINAS TALENT PLAN 公认职业成就RECOGNIZED PROFESSIONAL ACHIEVEMENT 境外派遣单位名称 NAME OF DISPATCHING INSTITUTION A
8、BROAD 派遣单位所在国家LOCATION OF DISPATCHING INSTITUTION ABROAD 在中国工作电话 BUSINESS TELEPHONENUMBER IN CHINA 在中国工作传真 BUSINESS FAX NUMBER IN CHINA 在中国工 作任务 JOB DESCRIPTION IN CHINA 列出曾就读的高等教育学校（含职业教育学校） LIST ALL HIGHER EDUCATIONAL INSTITUTIONS YOU HAVE ATTENTED (INCLUDING VOCATIONAL INSTITUTIONS) 名称 NAME 所在国家
9、LOCATION 就读时间 DATES OF ATTENDANCE 专业SPECIALITY 教育类型 EDUCATIONAL TYPE 学位 ACADEMIC QUALIFICATION 列出曾工作的单位 LIST ALL EMPLOYERS YOU HAVE WORKED FOR 名称 NAME 工作所在国家 LOCATION 起止时间 DATES 工作岗位OCCUPATION 职务 JOB TITLE 工作任务 JOB DESRIPTION 随行家属情况 ACCOMPANYING FAMILY MEMBERS 是否有家属随 行DO YOU HAVE ANY ACCOMPANYING ME
10、MBER? 人数 NUMBER OF THE ACCOMPANYING MEMBERS 随行家属姓名 NAME (As in Passport) 出生日期 DATE OF BIRTH(yyyy-mm-dd) 性别 GENDER 国籍 NATIONALITY 与 申请人关系 RELATIONSHIP TO THE APPLICANT 护照号码 PASSPORT NUMBER 在华紧急联系人EMERGENCY CONTACT PERSON IN CHINA 与申请人关系RELATIONSHIP TO THE APPLICANT 联系电话EMERGENCY CONTACT TELEPHONE NUM
11、BER 电子邮箱E-MAILADDRESS 申领外国人工作许可证 APPLICATION FOR FOREIGNERS WORK PERMIT 是否已入境 ARE YOU CURRENTLY IN CHINA? 持有签证种类 TYPE OF VISA HELD 入境时间 DATE OF ENTRY 签证号码 VISA NUMBER 您是否由于犯有任何罪行而曾经被逮捕或被判有罪，即使后来得到了赦免或收回等其他类似措施？ HAVE YOU EVER BEEN ARRESTED OR CONVICTED FOR ANY OFFENSE OR CRIME, EVEN THOUGH SUBJECT OF
12、 A PARDON, AMNESTY OR OTHER SIMILAR LEGAL ACTION? 是 YES 否 NO 您是否曾感染过对公共健康有影响的传染病或患过可造成危险的身体疾病或精神病？ HAVE YOU EVER BEEN AFFLICTED WITH A COMMUNICABLE DISEASE OF PUBLIC HEALTH SIGNIFICANCE OR A DANGEROUS PHYSICAL OR MENTAL DISORDER? 是 YES 否 NO 您是否曾违反中国法律，被中国政府递解出境？ HAVE YOU EVER VIOLATED THE LAW OF CHI
13、NA, AND DEPORTED FROM CHINA? 是 YES 否 NO 本人郑重承诺，在本国及境外无犯罪记录，来华工作后，将严格遵守中国法律法规，自觉服从聘请单位各项管理制度。本申请表上所做之回答均属事实且详尽，所附材料真实、有效，若所提交的内容被发现不实或不详，本人愿意承担法律责任。对所提交的全部申请信息和附件授权可以调查，包括我的雇佣情况、工作表现、工作能力 、教育、个人经历和无犯罪记录。如果我已超过 60 周岁，确保在中国工作期间有相应的医疗保险。 I SOLEMNLY PROMISE THAT I HAVE NO CRIMINAL RECORD BOTH AT MY HOME
14、COUNTRY AND ABROAD. WHEN I ARRIVE IN CHINA AND START TO WORK, I WILL STRICTLY ABIDE BY THE CHINESE LAWS AND REGULATIONS, AND CONSCIOUSLY OBEY THE MANAGEMENT SYSTEM OF THE EMPLOYING INSTITUTION. I CERTIFY THAT ALL THE ANSWERS TO THIS APPLICATION AND RELEVANT ATTACHMENTS TO IT ARE TRUE AND COMPLETED.
15、IF THE INFORMATION IS FOUND TO BE UNTRUE OR UNCOMPLETED, I AM AWARE THAT I NEED TO UNDERTAKE CORRESPONDING LEGAL RESPONSIBILITIES.I UNDERSTAND THAT ALL OF THE INFORMATION IN THIS APPLICATION AND DOCUMENTS SUBMITTEDWITH THIS APPLICATION MAY BE CHECKED BY RELEVANT PARTIES, INCLUDINGMY EMPLOYMENT, WORK
16、 PERFORMANCE,ABILITIES,EDUCATION,PERSONAL EXPERIENCES AND CONVICTION RECORDS.I CONFIRM THAT, IF I AM OVER SIXTY YEARS OLD,I WILL APPLY FOR MEDICAL INSURANCE COVERAGE AS ARE NEEDED DURING MY WORK PERIOD IN CHINA. 申请人签名 SIGNATURE OF APPLICANT 日期 DATE(yyyy-mm-dd) 用人单位承诺如实向行政机关提交有关 材料和反映真实情况，并对申请材料实质内容的真实性负责 ,承担相关法律责任。 THE EMPLOYER HEREBY DECLARES THAT ALL THE DOCUMENTS AND INFORMATIONS SUBMITTED TO THE AUTHORITY ARE TRUE,AND SHALL BE RESPONSIBLE TO THE AUTHENTICITY OF THE DOCUMENTS AND UNDERTAKE CORRESPONDING LEGAL RESPONSIBILITIES. 用人单位公章 （ Seal of Employer） 年 月 日 YYYY MM DD
