1、外国留学生入学申请表 （语言生）Application Form for Admission (language programs) ID:_ *Please complete the form in English or Chinese.个人信息 PERSONAL DETAILS英文姓 Family Name on Passport: 英文名 Given Names on Passport: 中文姓名 Chinese Name: 性别 Gender:男/M 女/F婚姻状况 Marital Status:已婚/Married 未婚/Single出生日期 Date of Birth: 年/Yr.
2、 月/Mo. 日/Date 出生地点 Country of Birth:照 片Photo国籍 Nationality: 护照号码 Passport No: 护照有效期 Passport Valid Until:年/Yr. 月/Mo. 日/Date签证类型 Type of Visa: 宗教 Religion: 母语 First Language: 职业 Occupation: 电子邮件 E-mail Address: 工作或学习单位 Employer or School Affiliated:海外地址 Address Overseas:街道 Street_城市 City_国家 Country_
3、邮编 Zip code_ 电话 Phone Number_邮寄地址（若与上述地址不同）Mailing Address (if different from above)： 街道 Street_城市 City_国家 Country_ 邮编 Zip code _ 电话 Phone Number_紧急联系人 Emergency Contact Person 与本人关系 Relationship 联系电话 Tel 最后学历 Highest Academic Degree Obtained:学习经历 Education Background: (from high school)学校名称 School/
4、 Institution attended专业Major开始时间（月/年） From: (mo/yr)结束时间（月/年）To: (mo/yr)所获学位 Name of qualification.留学期限 DATES OF STUDY留学期限 年 月 至 年 月Enrollment from Yr Mo to Yr Mo.申请项目 APPLYING PROGRAM申请类别 Applying as: 汉语普通班 Standard Chinese Language Program 商务汉语班 Business Chinese Training Program 汉语强化班 Intensive Chi
5、nese Training Program 短期生 Short Term Language Program ( )周 Weeks 中英双语班 Chinese-English Bilingual Program .汉语水平 LEVEL OF CHINESE是否有 HSK 证书？ Do you have an HSK (official test on Chinese Proficiency) certificate?没有 No. 有 Yes. 级别 HSK Level: _以前学过汉语吗？Have you ever learned Chinese? 没学过 No. 学过 Yes. _ 个月 Mo
6、nths汉语水平自我评价 Self-assessment:初级 Beginner 中级 Intermediate 高级 Advanced .项目费用 COURSE FEES经费来源 Type of Sponsorship:自费 Self-supporting 外国政府奖学金 Foreign Government Scholarship 交流生 Exchange program 其他 Other .未来学习计划 FUTURE STUDY PLANS在结束汉语学习后，我会留在中国大学继续学习。 I will study at a University in China after my Chine
7、se Course.了解途径 MARKETING如何了解到华师大? How did you hear about the language programs?教育机构 Educational agent 机构名称 Name of agent:学校网站 ECNU website 搜索引擎 Search engine(eg Google):报刊媒体 Newspapers 报刊名称 Name of newspaper:海外留学指南 A study abroad guide 指南名称 Name of guide: 亲友 Relatives or Friends其他 Other 请说明 Please g
8、ive details:.住宿信息 ACCOMMODATION您可以在留学生办公室网站上了解相关住宿信息，网址：http:/ details are available at: http:/ DECLARATION请核对是否已随申请表附上下述材料：Check that you have attached: 最高学历证书 Copies of your academic qualifications 护照复印件 Copy of your Passport 报名费 400 人民币 Application Fee: 400RMB (or 80USD)申请人保证：I hereby affirm that
9、:上述各项中所提供的情况是真实无误的；All the information given in this form is true and correct;在中国学习期间将遵守中国政府的法律和学校的规章制度；I shall abide by the laws of the government of P.R. China and the regulations of the University我已经认真阅读并明确了以上内容。I have read and understand the application conditions above.申请人签字： 日期：Applicants sign
10、ature: Date:委托人签字： 日期：Signature of person on behalf of applicant: Date:.其他信息 MORE INFORMATION报名费请汇至： Please send the application fee to the following account：1.帐号名称 (Account Name)： EAST CHINA NORMAL UNIVERSITY2.帐 号 (Account No.)： 4468729077453.开户银行 (Bank Name)： BANK OF CHINA SHANGHAI BRANCH4. SWIFT
11、号码 (SWIFT Code.): BKCHCNBJ3005.地 址 (Address): 200 MID YINCHENG ROAD, PUDONG AREA, SHANGHAI,CHINA6.请注明“报名费” 及护照姓名 Please indicate that the payment is for Application Fee and Applicants passport name.International Students OfficeEast China Normal UniversityRoom 236, Physics Bldg, 3663 Zhongshan Rd (N), Shanghai, China 200062中国上海中山北路 3663 号华东师范大学物理楼 236 留学生办公室 200062Tel: +86-21-62233283/62231997; Fax: +86-21-62238352E-Mail:
