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重重庆庆医科大学外国留学生入学申医科大学外国留学生入学申请请表表APPLICATION FORM FOR FOREIGNERS TO STUDY IN CHONGQING MEDICAL UNIVERSITY重庆医科大学外事处 Foreign Affairs Office, Chongqing Medical University, Chongqing 400016, P. R. China 电话/Tel: 86-23-68485041 传真/Fax: 86-23-68486812 电邮/E-mail: cqmuadmissionyahoo.com.cn 网址/Web: www.cqmu.edu.cn1. 申请人情况申请人情况/Personal information 护照名/Passport name 姓/Family name_ 名/Given name _ 国籍/Nationality _ 护照号码/Passport No. _ 性别/Gender_出生日期/Date of birth _/_/_(年/月/日 y/m/d) 婚否/Marital status_出生地点/Place of birth _ 宗教信仰/Religion _ 母语/Native language _最后学历/Education level_ 电话/Tel_ 电子邮件/E-mail _家庭住址/通讯地址/Permanent home address/Address for correspondence _2. 申请项目申请项目/Application 学习类别/Program 本科/Bachelor 硕士/Master 博士/Ph.D. 博士后/Post-doctorate 进修/Training 其他/Other_申请专业/Field of study 1)_2)_3)_学习时间/ Duration of the study 自/From_/_(年/月 y/m) 至/to _/_(年/月 y/m)住宿/Accommodation (Your choice will be for reference only due to the limited number of single rooms)本科/Bachelor 单人间/Single room 双人间/Double room硕士、博士/Master or PhD 双人间/Double room 校外/Off campus3. 学习经历学习经历(从初中开始从初中开始) /Education background (Starting from middle school)学校 时间 主修专业 所获证书 Institution Years attended (from/to) Fields of study Certificates obtained/to obtain_ _ _ _ _ _ _ _ _ _ _ _ _特长爱好/Special skills or interest _获奖情况/Awards received _曾发表的论文、著作/Academic papers and writings published _ 4. 工作经历工作经历(从当前工作开始从当前工作开始) /Full-time work experience (Starting from current position) 工作单位/Employer 时间/Time (from/to) 从事工作/Work engaged 职务及职称/Posts held _ _ _ _照片 Photo_ _ _ _ _ _ _5. 语言能力语言能力/Language proficiency 希望授课语言为/Media of instruction preferred 英语/English 汉语/Chinese(HSK 考试/HSK test level _)6. 亲属情况亲属情况/Family members 姓名/Name 年龄/Age 职业/Occupation 电话/电子邮件/Tel/E-mail 父亲/Father_ _ _ _母亲/Mother _ _ _ _配偶/Spouse_ _ _ _ _ _ _ _7. 推荐人情况推荐人情况(本科申请者不填)/Information for referees (Not required for Bachelors program applicants)姓名/Name 工作机构/Organization 职务/Position 电子邮件/E-mail_ _ _ _ _ _ _8. 经济保证人情况经济保证人情况/Financial sponsor姓名/Name _地址及电话号码/Address & Tel 与申请人关系/Relationship with the applicant _ 保证人签名/Sponsors signature _ 9. 在华事务联系人或机构在华事务联系人或机构/Person for agency to act on your behalf in China_ 申请人保证/I hereby affirm:1. 上述情况真实无误。I have reviewed the above information, and it is true and complete to the best of my knowledge.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。I shall abide by the laws of the Chinese government and the regulations of Chongqing Medical University.申请人签字/Applicants signature 日期/Date 以下各栏由学校填写以下各栏由学校填写/For official use外事处意见研究生院意见导师意见
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