护照用名

姓/Family Name

照片

photo

名/Given Name

国籍/Nationality

护照号码

 Passport
No.

出生日期

Date of Birth

年       月      日

Year     Month    Day

出生地点

Place of Birth

性  别

Sex

宗  教

Religion

婚姻状况

Marital Status

□ 单身/ Single              □ 已婚/ Married               □ 离异/ Divorced

国籍国通讯地址

Home Country Address

国家/Country                     城市/City                       电话/Tel:                              

地址/Address                                                                             

目前邮寄地址

Mailing Address

国家/Country                     城市/City                       电话/Tel:                        地址/Address                                                                             

电话/传真/电子邮箱

Tel./Fax/Email Address

电话/Tel:                              传真/Fax:_________________________  

电子邮箱/E-mail:                                        (请准确填写邮箱地址，电子版通知书会通过邮箱发送给你/Be sure to provide available
Email address, Electronic Admission Letter will be sent to you via Email)

教育情况

Educational Background

学校              在校时间              所获证书、学位          主修专业

    Institution       Years attended (from/to)        Diploma
received        Fields of study

_____________    __________________      __________________      _______________

_____________    __________________      __________________      _______________

_____________    __________________      __________________      _______________

工作单位

Employer

职业

Occupation

经济来源

Source of
Funding

奖学金/Scholarship □   自费/Self-Supporting □   其他/Other □

在华事务担保人及电话

Guarantor in China & Tel

名称/Name:_________________________  电话/Tel: _________________________

推荐单位及电话

Reference &Tel.

名称/Name:_________________________  电话/Tel: _________________________

语言能力

（“优良、中、差”）

Language
Proficiency

(“Good”,
“Fair” or “Poor”)

汉语 Chinese                     ;  HSK               级;  Learning Hours 学时             

英语 English            ;    TOEFL(score)         ;   IELTS(score)        

其他 Others
______________

来华学习计划

Proposed Study at SCUT

□汉语进修生/Chinese
Language Student  □国际预科/International
Foundation  □交换生/Exchange
Student

□本科生/Undergraduate
Candidate（授课语言/Language of construction □英语/English  □中文/Chinese）

□硕士研究生/Master’s Degree
Candidate □博士研究生/Doctor’s Degree Candidate

申请专业

Major You Are Applying For

研究方向

Research Area

(For Postgraduate Candidate)

申请专业学习时间Duration of Study

自/From：________月/Month___________ 年/Year 至/To：_________月/Month__________ 年/Year

是否需要汉语补习

Do You Need Chinese Study Prior to the
Specialized Study?

□   是/Yes 自/From：________月/Month_________年/Year 至/to： ______月/Month_________年/Year

(汉语补习不计在专业学习时间内/Chinese study is not included in the
length of the specialized study)

□ 否/No

请研究生和高级进修生用中文或英语填写研究专业的补充说明（请附另页）：

Any Other Information
You Consider Relevant to This Plan (Postgraduate and senior advanced students
are requested to write in Chinese or English. Use an attached page.)

住宿

Accommodation

所有国际学生在准时来校报到注册期间将被安排入住单人房（数量很少），双人房及四人房。不按时报到的新生需自行解决宿舍问题。

All
international students who register on time will be arranged to live in a
single (limited amount), double, or four-bed room, we will NOT guarantee accommodation
for those who register behind schedule.

您是通过什么渠道获得我校的信息/ How did you
get information about SCUT?  □中介/Agency
:________________

□教育展/Education
Fair  □华工学生/SCUT student（姓名/name
_____________________） □亲戚或朋友/Relative or friend

□网络/Internet (□ Search
engine:_______________  □ Other website:
____________________)  □其他 Others
_________

所附材料（请在所附材料前划“√”标明）/Materials Attached (Please Indicate with “√” in the Bracket.)

□   护照复印件/ One Copy of the Applicant’s Passport.

□   本人最后学历成绩单复印件（须公正）/Most up-to-date
transcript (Notarized).

□   本人最后学历证书复印件（须公正）/ Diploma from
most recently graduated institution (Notarized).

□   外国人体体格检查记录（复印件）/ Foreigner
Physical Examination Form (Photocopy).

□   来佛山科学技术学院学习计划/ Study Plan while
at FOSU.

□   所发表文章等/ Articles or
Papers Written or Published.

□   美术作品（本人作品彩照六张）（只限申请美术专业的申请人）

Examples of Art (6 color pictures) (Only for the
applicants applying for Fine Arts )

□   其他附件（请列出）/Other Attachments (List Needed)：_________________________________________

申请人保证：

1．   上述各项中所提供的情况是真实无误的；

2．   在中国学习期间遵守中国政府的法律和学校的规章制度，尊重学校的教学安排。

3．   按规定期限修完学业，按期回国，不无故在华滞留。

I hereby affirm that:

1. All the information in this form is true and correct;

2. I shall abide by the laws of the Chinese Government and the
regulations of the School, and will concentrate on my studies and

research, and will follow the
teaching programs made by the university..

3. 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.

日期：     年       月     日               申请人签名：:______________________

Date:      Y       M     D                 Applicant’s Signature

(无此签名，申请无效/Only with signature should the application be
valid)