Application Form for AHJZU Scholarship

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安徽建筑大学外国留学生奖学金申请表

APPLICATION FORM FOR AHJZU SCHOLARSHIP 

 

 

1.  申请人情况/Personal Information:

护照用名/ Name as in Passport:  

/Family Name: __________________________________

    /Given Name: ___________________________________

    国籍/Nationality: ___________ 护照号码/Passport No.: ____________

    出生日期/Date of Birth: /Year_______/Month______/Day_______

    出生地点/Place of Birth: 国家/Country:_____________城市/City:____________

    性别/Sex:   /Male □   女/Female □  

婚姻状况/Marital Status: 已婚/Married  未婚/Single  丧偶/widowed  离异Divorced □

    母语/Native Language:                     宗教/Religion:                           

    当前联系地址/Present Address:                                            

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

永久通信地址/Permanent Address:                

                                                                           

2. 受教育情况/Education Background:


学校

Institutions

在校时间

Years Attended

(from/to)

主修专业

Fields of Study

毕业证书及学位证书

Certificates Obtained

 

 

 

 

 

 

 

 

 

 

 

 

    

3. 工作经历/Employment Record:

工作单位

Employer

起止时间

Time (from/to)

从事工作

Work Engaged

职务及职称

Post/Academic Status

 

 

 

 

 

 

 

 

 

4. 语言水平/Language Proficiency:

 a) 汉语/Chinese:

很好/Excellent:□  好/Good □  一般/Fair □  差/Poor □  不会/Dont Know

HSK 考试等级或其他汉语水平证书/ Level of HSK or other certificates which can show your Chinese level:__          ______________________________________

 b) 英语/English:

很好/Excellent:□  好/Good:□  /Fair:□  差/Poor:□  不会/None:□

我可以用英语学习专业课程/I can learn the special courses in English:

/Yes ¨/No

 c) 其他语言/Other Languages:________________水平/Proficiency                    

5. 来华学习计划/Proposed Study in China:


a)本科(学士)/Undergraduate (Bachelors Degree) Program  □

硕士学位/Masters Degree Program

普通进修生/General Scholars  

汉语预科生/Chinese Preppy    

 b) 学习专业 / Major of Study:                                               

c) 学习时间 / Duration of the Study:

/From______/Year      /Month /To______/Year       /Month

  1. 申请人是否曾在华学习或任职/Have you ever studied or worked in China?

        /Yes: □ 学习或任职单位/Institution or Employer:                                       

    在华时间/Time in China:

    /From:_____/Year      /Month/To:_____/Year____/Month    

    /No: 


    申请人保证书

    Letter of Guarantee

     

     

    我保证申请表中所填写的所有内容和提供的材料真实无误;

    I hereby affirm that all the information and materials given in this form are true and correct.

     

    我保证除安徽建筑大学奖学金外未申请同一时间的其他来自中国的奖学金;

    I ensure that besides the AHJZU scholarship, I have not applied for any other Chinese scholarships for the same study period.

     

    在华期间,我将遵守中国的法律、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 which are deemed to be adverse to the social order of China and are inappropriate to my capacity as a student.

 

我在享受奖学金期间不无故要求变更学校和所学专业;

During the period of enjoying AHJZU scholarship, I shall not apply for any changes of institution and specialty of study without valid reasons.

 

在学期间,我将遵守学校的校纪、校规,尊重学校的教学安排;

    During my study in China, I shall abide by the rules and regulations of Anhui University and follow the teaching programs arranged by the university.

 

我将按照规定参加安徽建筑大学奖学金年度评审;

     I shall go through the procedures of the annual assessment of AHJZU scholarship status as required.

 

我将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 study program in China, and will not extend my stay in China without valid reasons.

 

如违反上述保证而受到中国法律、法规或校纪、校规的惩处,我愿意接受安徽建筑大学奖学金管理委员会中止或取消奖学金及其它相应的处罚。

     If I violate the Chinese laws or decrees as well as the rules and regulations of Anhui University, I will not lodge any appeal against the decision of AHJZU scholarship administration on suspending or withdrawing my scholarship, or other corresponding penalties.

 

 

 

申请人签字/Signature of the Applicant:                               

日期/Date:__ ______________________________   

(无此签名,申请无效/The application is invalid without the applicant’s signature
所附材料情况

(请在所附附件前划X’标明

Materials Attached (Please Indicate with X in the Bracket)

 

 

本人护照复印件/A Copy of the Passport.

本人最后学历成绩单复印件(须公证)/Transcripts of Study Records of the Most Advanced Studies (Notarized Photocopy).

本人最后学历证书复印件(须公证)/Diploma of the Most Advanced Studies (Notarized Photocopy)

高中/High School □       本科/Bachelor’s Degree □        硕士/Master’s Degree □  

汉语水平证书 / Certificate of Chinese level(如HSK

两封推荐信(申请硕士需提供)/Two Letters of Recommendation (for graduate programs)

来华学习计划(申请硕士需提供)/ Study Plan in China (for graduate programs)

所发表的文章等/ Articles or Papers Published.

其它附件(请列出)/Other Supporting Documents (A List Is Needed)

 

__________________________________________________________

Application Form for AHJZU Scholarship.doc

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