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1、附件3广西政府东盟国家留学生奖学金申请表（全额奖学金）GUANGXI GOVERNMENTFULL SCHOLARSHIP APPLICATION FORM FOR ASEAN STUDENTS照片 Photo请申请人用中文或英文填写此表格。请用电脑打印或用蓝色或黑色钢笔认真书写表格内容。请在所选项框内划X表示。不按规定填写的表格将视作无效。Please complete the form in Chinese or English. theform with computer, or write legibly in black or blue ink. Please indicate wi
2、th X in the blank chosen. Any forms that donot follow the notes will be invalid.1. 申请人情况/Personal Information:护照用名/Passport Name:_ 姓/Family Name: _ 名/Given Name: _国籍/Nationality: _ 护照号码/Passport No.: _出生日期/Date of Birth: 年/Year_月/Month_日/Day_ 出生地点/Place of Birth: 国家/Country:_ 城市/City:_男/Male： 女/Fema
3、le： 已婚/Married： 未婚/Single： 其它/Other：母语/Native Language:_ 宗教/Religion: _当前联系地址/Present Address:_电话/Tel: _ 传真/Fax: _E-mail: _永久地址/Permanent Address: _2. 受教育情况/Education Background:学校/ Institutions_在校时间/ Years Attended (fromto)_主修专业/ Major of Study_毕业证书及学位证书/ Diploma or Degree Obtained or To Obtain_ _
4、_3. 工作经历/Employment Record:工作单位/ Employer_起止时间/ Time (fromto)_从事工作/ Work Engaged_职务及职称/ Posts and Titles Held_4. 语言能力/Language Proficiency:a) 汉语/Chinese: 很好/Excellent 好/Good 较好/Fair 差/Poor 不会/None HSK 考试等级/ Level of HSK test _b) 英语/English: 很好/Excellent 好/Good 较好/Fair 差/Poor 不会/None 我的英语水平可以用英语学习/I
5、can be taught in English: 是/Yes 否/No c) 其他语言/Other Languages:_5. 来我校学习计划/Proposed Study at Our Universitya)研究学者/Research Scholar 汉语进修生/Chinese Language Student 本科生/Bachelors 硕士生/Masters博士/Doctors 其它/Others b) 申请来我校学习的专业或研究专题/ Program or Field of Study at our University_ _c) 申请学习时间/Duration of Study:
6、自/From：年/Year_ 月/Month_ 至/To：年/Year_ 月/Month _6. 拟在我校学习或研究的内容（可另附纸）/ Please Describe the Details of your Study or Research Plan at our University (an extra paper can be attached if this space is not enough):_7. 曾发表的主要学术论文、著作及作品/Academic Papers, Writing & Art Works Published:_8. 申请奖学金类别/Scholarship A
7、pplied:全额奖学金/Full Scholarship 推荐您申请我校奖学金的机构或个人/Please Specify the Organization or Person Recommending you for this Scholarship: _9. 申请人在华事务联系人或机构/The Guarantor Charging Your Case in China: 名称/Name:_ 电话/Tel: _传真/Fax: _ 地址/Address:_10. 申请人是否曾在华学习或任职/Have you ever Studied or Worked in China?是/Yes: 学习或任
8、职单位/Institution or Employer: _在华时间/Time in China: 自/From: 年/Year_ 月/Month_ 至/To: 年/Year_ 月/Month _否/No:11. 申请人亲属情况/Family Members of the Applicants: 姓名 年龄 职业 Name Age Employment配偶/Spouse: _ _ _父亲/Father: _ _ _母亲/Mother: _ _ _申请人保证/I Hereby Affirm That1. 申请表中所填写的内容和提供的材料真实无误。All information and mater
9、ials given in this form are true and correct.2. 在华期间，遵守中国的法律、法规，不从事任何危害中国社会秩序的、与本人来华学习身份不符合的活动。During my stay in China, I shall abide by the laws and decrees of the Chinese government, and will not participate in any activities in China which are deemed to be adverse to the social order of China and
10、 are inappropriate to the capacity as a student.3. 来华后服从学校安排，不得无故要求变更学校和所学专业。I will agree to the arrangements of my institution and specialty of study in Guangxi made by the University, and will not apply for any changes without valid reasons.4. 在学期间，遵守学校的校纪、校规，全力投入学习和研究工作，尊重学校的教学安排。During my study
11、in China, I shall abide by the rules and regulations of the host university, and concentrate on my studies and researches, and follow the teaching programs arranged by the university.5. 按规定期限修完学业，按期回国，不无故在华滞留。I shall return to my home country as soon as I complete my scheduled program in China, and
12、will not extend my stay without valid reasons.6. 如违反上述保证而受到中国法律、法规或校纪、校规的惩处，我愿意接受中止或取消奖学金及其它相应的处罚。If I am judged by the Chinese laws and decrees and the rules and regulations of the university as having violated any of the above, I will not lodge any appeal against the decision of withdrawing my scholarship, or other penalties. 申请人签字/Signature of the Applicant:_ 日期/Date:_接收学校领导签字:_ 接收学校公章：
