“一带一路”国家高等教育机构卓越女性领导力培训项目申请表
application form of thewomen’s leadership training program for excellent women from higher education organizations of “the belt and road” countries
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护照用名/name in passport
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姓/family name
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中文名/chinese name
(if applicable)
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照 片
photo
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名/given name
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国籍
nationality
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出生地点
place of birth
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出生日期
date of birth
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年 月 日
/year /month /date
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男 □male
女 □female
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已婚□married
未婚□single
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护照号码
passport no.
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宗教/religion
(if applicable)
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最后学历/highest education
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现职务/
title & job positions
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现工作单位/current employer
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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.
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目前通讯地址/current address if different:
电话/tel: 传真/fax: email:
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申请专业
application major
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研究方向
research topic
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现有英语水平/english language proficiency:
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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
______________________ ____________ ____________________ _________________
______________________ ____________ ____________________ _________________
______________________ ____________ ____________________ _________________
______________________ ____________ ____________________ _________________
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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. the applicant 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: email:
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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 participate in the training program held at china women’s university. i pledge the following terms during my training:
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 training in china.
3. 遵守学校的各项规章制度；
i will observe all rules and regulations of the university.
申请人本人签字/signature of the applicant:
日期/date:
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