1、国 际 交 流 合 作 处 International Exchange & Cooperation Office.No.13 Yanta Road,710055, Xian, Shaanxi, CHINA ,Tel: 0086-29-82202169 ,Fax: 0086-29-82224571=西安建筑科技大学交换留学生抵达目的国(地区)信息表The Host Country (Region) of Arrival Information Form for Exchange Students of XAUAT 第 号 国际交流合作处制表姓名Name性别Gender出生年月Birthday学
2、院/专业/班级College/Major/Grade学生证号Student No.身份证号Identity Card No.所持证件号(护照或通行证)Passport No.抵达国(地区)名称/地址/联系方式Host Country (Region) Information抵达单位名称(院校/科研机构)Host University Information个人在国外的住址及联系方式Foreign Address & Contact Information抵达时间Arrival Time预计回国时间Home Time留学目的 Purpose For Studying Abroad:(简述留学目的
3、、个人学习及科研计划等)对方单位/部门负责人:Person in Charge: (签字 Signature)对方单位:Host University:(公章 Official Seal)注:本表由学生本人在抵达留学目的国后一周内完成, 表格电子版发送至 并发传真至 0086-29-82224571.我校将以本表作为学生按时抵达目的国的凭证,否则将不予承认在外留学成绩,后果由学生本人承担。This form is very important for students. Students need to complete the form within one week when they have arrived destination and sent it back to .