2018 imsw program in women’s leadership and social development——application form-九游会体育

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:

我愿意到中华女子学院学习，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: