1、 - 5 （就业类） 1就业类居留许可资格面谈记录表Qualification Interview for Residence Permit for Employment注意： 此表为审批重要依据之一，申请人须如实填报并承担相关责任。使用黑色笔墨，工整填写。NOTE: This form is very important for your application. You shall complete it with BLACK ink truthfully and neatly and shall be responsible for the information you provide
2、.I. 个人信息 Personal Information姓名 full name 性别 sex 出生日期 date of birth出生地 place of birth国籍 nationality 护照 passport No. 护照签发地及有效期（of passport）place of issue_ & expiry date _ 签证种类visa type签证号码 visa No. 签证签发地(visa) issued at 签证有效期至(visa) valid until入境次数entry(s)最近一次入境口岸及时间 port & date of latest entry _ &_
3、入境后可停留天数 permitted days of stay after entry婚姻状况 marital status single 单身 married 已婚 divorced 离异 widowed 鳏居 separated 分居 在深圳就职单位名称 Full name of your present organization of employment in Shenzhen: 上述单位地址及联系电话 Address and phone number of the above institution:本人在深圳住址及联系电话 Your address and phone number
4、 in Shenzhen and e-mail address: Add:Tel: E-mail:语种 languages语言能力language ability熟练程度proficiencyfluent OK fluent OK fluent OK II. 家庭信息 Family Information (no matter where they are now)姓 名 full name 性别sex出生日期birth date关系relationship国籍nationality职业occupation此外，如果有家庭成员随行，或者有直系亲属在华居住或工作，请提供他们的姓名、与本人关系、工
5、作单位或住址。Besides, if you have any accompanying family members or immediate relatives in China, what is their status or address in China? - 5 （就业类） 2（Go to next 3 pages 后续三页） Policeperson in charge 经办民警签名：III. 主要经历 Major Experience1. 请提供你在所属国家的常住地址 Please give your permanent address in your home countr
6、y:地址 Add. 邮政编码 Post code 家庭电话 Tel. (区号 area code) (号码 phone number) 2. 请说明你第一次中国签证的情况 Please give details of your first Chinese visa: 签证种类 签发日期 签发地 type of visa date of issue place of issue 3. 请说明你首次取得中国签证以来进入中国的情况 Please give details of your entry(s) into China since you acquired the first Chinese
7、visa.a. 入境总次数 Total number of entries: 5 次之内 and under 6-10 次 超过 more than 10 次b. 到访过的城市以及目的 Chinese cities you have visited and purpose of each visit:city name for purpose for for for for for for for 4. 如果你曾申办过中国居留许可，请说明最近一次的情况：If you had a Chinese residence permit before, please give details of th
8、e last one:签发时间 签发地 居留目的time of issue place of issue purpose of residence 就业或留学单位institution where you worked or studied 5. 列出最近十年内你曾去过的其他国家/地区以及时间、目的。List your visits to other countries/regions in the last ten years.国家/地country/region时间 time (yymmyymm)目的purpose国家/地区country/region时间 time (yymmyymm)目
9、的purpose6. 列出你曾经就读的主要院校（高中以上）List all major educational institutions you have attended (senior high school and above). 院校名称institution 专业major在校时间 time(yymmyymm)学校地址(精确到市)location (specific to city)- 5 （就业类） 37. 简述你的工作经历 Describe your working experience.工作时间 time(yymmyymm)单位名称institution 地址及其电话addre
10、ss & Tel. 职位position证明人及其电话reference & Tel.8. 如果你曾在所属国家政府部门工作，请说明你离职的原因。If you ever worked in any government departments of your country, please explain why you left the job.（if not ,write down no /none ）9. 简述你在所属国家服役的情况，说明时间和所属部队。Describe your military service in your home country, giving the time
11、and the unit you belonged to. （if not ,write down no /none ）IV. 此次就业相关信息 Information Regarding Your Present Work Here1. 你什么时候到这家单位/公司工作的？有没有签订劳动合同？合同期多长? When did you come to the said institution/company? Have you signed any employment contract? What is the length of the contract?2. 你是如何找到目前这份工作的？ H
12、ow did you get the present job?3. 你目前的工作职责是什么？What are your precise responsibilities at this institution/company?4. 你有什么专业特长可以符合现任工作职位的要求？What special skills do you have that qualify you for the present post?V. 其他信息 Other Information 1. 你参加过何种社会组织？如果没有，请注明。List major social organizations, either hom
13、e or abroad, you have been affiliated to.(if not ,write down no /none )- 5 （就业类） 42. 你有何宗教信仰？如果没有，请注明。What is your religious belief? (if not ,write down no /none )3. 你是否曾牵涉刑事或民事诉讼? 如有，陈述事由及结果。Have you ever been involved in any criminal or civil procedures? If any, specify the reason(s) and result(s)
14、.4. 你有否参加过任何非法组织或非法活动？如有，请说明。Have you ever been involved in any illegal organizations or activities? If yes, specify.5. 如果你在所属国境外遇到危难情况，你最有可能求助于：When outside of your home country and in case of emergency, you are most likely to seek help from: 当地警方 local police yes no (choose with “”)使领馆 embassy/con
15、sulate yes no (choose with “”)其他机构 other organizations: 你最有可能采取的求助方式是 You are most likely to seek help by 申请人声明：本人已经阅读并明白表格里所列的所有问题，我保证表格中所回答的是真实和正确的，我理解如果我未能完整填写此表或未能提供所要求的材料，我的申请可能因材料不足而被延误或拒签。Applicants statement: I certify that I have read and understood all the questions set forth in this form
16、and the answers on this form are true and correct to the best of my knowledge and belief. I understand that failure to fully complete this form or to provide the requested documents may result in my application being delayed or refused on account of insufficient evidence being provided.年审提示：每年 5 月 1
17、5 日至 6 月 15 日，请到南山公安分局交验居留许可。详细情况请留意南山政府在线（ 。年审请提前 3-5 天进行电话预约。联系电话：8446-6158 。Reminder on Annual Examination: Please submit your residence permit for examination to Nanshan Public Security Branch between 15 May and 15 June each year. For detailed information, please log on to the website of Nanshan
18、 Government Online or Shenzhen PSB Entry-Exit Department . You should call to make an appointment 3-5 days in advance. Contact number: 8446-6158。 申请人签名 Applicants signature: 日期 Date: 申请人姓名楷书对照 Applicants full name in print (for comparison with signature): 翻译人员签名 Signature of interpreter: 语种 Language： 翻译人员服务机构名称：Name of institution the interpreter is affiliated to: 机构地址 Address: 联系电话 Contact phone number: Policeperson in charge:- 5 （就业类） 5经办民警签名： 备注 Remarks:
