护照用名/Name in passport

姓/Family name

中文名/Chinese name

(if applicable)

照片

Photo

名/Given name

国籍

Nationality

出生地点

Place of birth

出生日期

Date of birth

年月日

/year       /month      /date

男□Male

女□Female

已婚□Married

未婚□Single

护照号码

Passport No.

宗教/Religion

(if applicable)

最后学历/Previous education

现职务/Job Duties

现工作单位/Current employer

永久通讯地址/Permanent mailing address:

电话/Tel:                         传真/Fax:                   

E-mail 1:

E-mail 2（backup）:

Note: It is highly suggested that provide two email addresses and avoid to use Gmail for technical reasons.

目前通讯地址/Current address if different:

电话/Tel:                         传真/Fax:                    E-mail:

申请专业

Application major

研究方向

Research topic

现有英语水平/English language proficiency:

本人简历/Curriculum vitae

单位时间（年/月——年/月）主修专业

Previous and Current Education & Employer        Years Attended(from/to)                Fields of Study

______________________  ____________        ____________________             _________________

______________________  ____________        ____________________             _________________

______________________  ____________        ____________________             _________________

______________________  ____________        ____________________             _________________

家庭主要成员/Family members

姓名/ Name              关系/ Relation      职业/ Employment电话/ Tel:

______________            ______________           __________________       ______________

______________            ______________           __________________       ______________

______________            ______________           __________________       ______________

紧急联系人（紧急联系人可以是父母或者亲戚朋友，国籍不限，但学生不能做紧急联系人）/Emergency contact during your stay at BLCU(Contact person can be a parent or relative of applicants. Student cannot be the contact person )

姓名/ Name:              国籍/ Nationality:            与本人关系/Relationship to the applicant: 

永久通讯地址/Permanent mailing address:

单位/ Name of employer:

住宅电话/Home Tel:                         办公室电话/Office Tel:

传真/ Fax:                                  E-mail:

我愿意到UG环球360官方网站学习，在学习期间保证做到下列各项/I am willing to study at China Women’s University. I pledge the following terms during my study:

1.    遵守中华人民共和国法律；

I will abide by the laws of the People’s Republic of China.

2.    不从事学习目的以外的活动；

I will not engage in activities bearing no relation with my academic pursuit in China.

3.    遵守学校的各项规章制度，努力学习；

I will study industriously and observe all rules and regulations of the University.

学生本人签字/Signature of the applicant:

日期/Date: