1、外国留学生校长奖学金申请表APPLICATION FORM FOR PRESIDENT SCHOLARSHIP OF SOUTHWEST UNIVERSITY请用中文或英文填写此表格。请用电脑填写本表格内容后打印出来，请在所选项框内划X表示。不按规定填写的表格将视作申请无效。Please read carefully the important notes on the last page before filling out the form. Please complete the form in Chinese or English .This form should be filled
2、 in on PC and print it out. Please indicate with X in the blank chosen. Any forms that do not follow the notes will be invalid.1. 申请人情况/Personal Information护照用名/Passport Name姓/Family Name: 名/Given 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
3、Birth: 国家/Country: 城市/City: 性别/Gender 男/Male 女/Female 婚姻状况/Marital Status 已婚/Married 未婚/Single 其它/Other 母语/Native Language 宗教/Religion 当前联系地址/ Present Address: 电话/Tel: 传真/Fax: E-mail: 永久通信地址/Permanent Address: 接收录取通知书地址（包含国家、省州、城市、街道、邮编信息）/Address for receiving admission notice(Street, City, State/P
4、rovince, Country, Post code): 2. 受教育情况/Education Background学校 在校时间 主修专业 毕业证书及学位证书Institution Years Attended(from/to) Fields of Study Certificates Obtained or To Obtain3. 工作经历/Employment Record工作单位 起止时间 从事工作 职务及职称Employer Time(from/to ) Work Engaged Posts Held照片Photo4. 语言能力/Language Proficiency)a) 汉语
5、/Chinese: 很好/Excellent 好/Good 较好/Fair 差/Poor 不会/None HKS 考试等级或其他类型汉语考试成绩/Level of HKS test or other certificates which can show your Chinese level:b) 英语/English: 很好/Excellent 好/Good 较好/Fair 差/Poor 不会/None c) 其他语言/Other Languages:d) 申请授课语言/Language of Instruction：汉语/Chinese 英语/English 5. 来华学习计划/Propo
6、sed Study in China a)本科生/Bachelors Degree Candidate: 硕士研究生/Masters Degree Candidate: 博士研究生/Doctoral Degree Candidate: b) 申请来华学习专业或研究专题/Program or Major of Study in SWU:c) 申请来华专业学习时间/Duration of the Major Study in China:自/From: 年/Year 月/Month 至/To: 年/Year 月/Monthd) 是否需要补习汉语/Do You Need Elementary Chi
7、nese Study Prior to the Major Study? 是 /Yes: 请填写申请汉语补习时间（不计在专业学习时间）/If “Yes”, please fill in the duration of your elementary Chinese study (not included in the length of the major study ). 否 /No: 6. 申请奖学金类别/Category of scholarship you apply for一等奖/First Prize(tuition-free and monthly living allowanc
8、e) 二等奖 Second Prize (tuition-free) 7. 拟在校学习或研究的详细内容（可另附纸）/Please Describe the Details of your Study or Research Plan in SWU (an extra paper can be attached if this space is not enough)8. 曾发表的主要学术论文、著作及作品/Academic Papers, Writing & Art Works Published9. 申请人在华事务联系人或机构/ The Guarantor Charging Your Case
9、 in China: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/Have you ever Studied or Worked in China?是/Yes 学习或任职单位/Institution or Employer在华时间/Time in China: 自/From: 年/Year 月/Month 至/To: 年/Year 月/Month否/No 11. 申请人亲属情况/Family Member of the Applicants:姓名 Name 年 龄 Age 职业 Occupation配偶/Spouse: 父亲/Fa
10、ther:母亲/Mother:所附材料情况（请在所附附件前划X标明）/Materials Attached (Please Indicate with X in the Bracket.): 本人最后学历证书复印件（须公证）/Diploma of the Most Advanced Studies (Notarized Photocopy)：高中/Senior high school 本科/Bachelors 硕士/Masters 博士/Doctors 其它/Others 本人最后学历成绩单复印件（须公证）/Transcripts of the Most Advanced Studies (N
11、otarized Photocopy). 两封副教授或教授推荐信/Two Letters of Recommendation by associate professors or professors. 来华学习计划/ Study Plan in China. 外国人体格检查记录（复印件）/ Foreigner Physical Examination Form (Photocopy). 护照个人信息页（复印件）/Personal information Page of Passport (Photocopy) 所发表的文章等/ Articles or Papers Written or Pu
12、blished (Photocopy). 美术作品（本人作品彩照六张）、音乐作品（本人音乐作品盒式录音带一盘）（只限申请美术和音乐专业的申请人）/Examples of Art (6 color pictures) and Music (1 audio tape) Work (Only for the applicants applying for Fine Arts and Music). 其它附件（请列出）/Other Attachments (List Needed)：_ 注：1）全部使用A4纸准备所有申请材料。Please use DIN A4 to prepare all the a
13、pplication materials. 2)无论申请人是否被录取，所有申请材料恕不退还。Whether the candidates are accepted or not, all the application materials will not be returned. 申请人保证/I Hereby Affirm That: .1. 申请表中所填写的内容和提供的材料真实无误；All the information and materials given in this form are true and correct.2. 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
14、序的、与本人来华学习身份不符合的活动；During my stay in China, I shall abide by the laws and decrees of the Chinese government, and will not participate in activities in China which are deemed to be adverse to the social order of China and are inappropriate to the capacity as a student.3. 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
15、重学校的教学安排；During my study in China, I shall abide by the rules and regulations of the host university, concentrate on my study and researches and follow the teaching programs arranged by the university.4. 按照规定参加西南大学校长奖学金年度评审；I will go through the procedures of the Annual Evaluation of SWU President S
16、cholarship as required.5. 按规定期限修完学业，按期回国，不无故在华滞留；I shall return to my home country as soon as I complete my scheduled program in China and will not extend my stay without valid reasons.6. 我保证，未同时接受其它任何渠道的奖学金或资助；I declare that this is the only Scholarship I am applying for at present.7. 如违反上述保证而受到中国法
17、律、法规或校纪、校规的惩处，我愿意接受西南大学中止或取消奖学金及其它相应的处罚。If I am judged by the Chinese laws, decrees and the rules and regulations of the university for having violated any of the above, I will not lodge any appeal against the decision of Southwest University on suspending, withdrawing or other penalties.申请人签字/Signature of Applicant: 日期/Date:(无此签名，申请无效/The application is invalid without the applicants signature )
