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学校在校时间 InstitutionsYears Attended (from/to)	主修专业 Fields of Study	毕业证书及学位证书   Certificates Obtained or To Obtain
_____________________	_____________________	_____________________
_____________________	_____________________	_____________________
_____________________	_____________________	_____________________

3. 工作经历/Employment Record:

起止时间工作单位 EmployerTime (from/to)	从事工作 Work Engaged	职务及职称 Posts 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 考试等级或其他类型汉语考试成绩/ Level of HSK test or other certificates which can show your

Chinese level:______________________________________________________________________________

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 can be taught in English: 是/Yes□ 否/No □

c).其他语言/Other Languages:___________________________________________________________________

5. 学习计划/Proposed Study Plan in BUCT:
a).本科生/Bachelor’s Degree Candidate：□                    
     硕士研究生/Master’s Degree Candidate：□                    普通进修生/General Scholar：□
     博士研究生/Doctor’s Degree Candidate：□                  高级进修生/Senior Scholar：□

b).申请来华学习专业或研究专题/Subject or Field of Study in China:____________________________________

c).申请专业学习/进修时间/Duration of the Major Study:

自/From：年/Year_________月/Month _________至/To：年/Year_________月/Month _________
d).是否需要补习汉语/Do You Need Elementary Chinese Study prior to the Major Study?
是/Yes：□ 请填写申请汉语补习时间（不计在专业学习时间内）/ If ‘Yes’, please indicate the duration of your elementary Chinese study(not included in the length of the major study).

自/From：年/Year_______月/Month ________

否/No:：□

6. 拟在华学习或研究的详细内容（可另附纸）/ Please Describe the Details of your Study or Research Plan in BUCT
(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 Applied:
A. 全额奖学金/Full Scholarship: □ (只包括学费only tuition fee included)
B. 部分奖学金/Partial Scholarship: □ (只包括一半学费only half tuition fee included)

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．紧急联系人:Contact person in case of emergency:
姓名Name:                                        关系Relation to you:
地址Address:
电话Telephone:                                邮件  Email: 

11. 申请人亲属情况/Family Members of the Applicants:

姓名 Name	年龄 Age	职业 Employment
配偶/Spouse: _______________________	______________	_____________________________
父亲/Father : _______________________	______________	_____________________________
母亲/Mother: _______________________	______________	_____________________________

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所附材料情况（请在所附附件前划‘X’标明）/Materials Attached (Please Indicate with ‘X’ the Bracket.):in

□ 两封推荐信/Two Letters of Recommendation.
□ 本人最后学历成绩单复印件（须公证）/Transcripts 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)：
 本科/Bachelor’s □   硕士/Master’s □     博士/Doctor’s □    其它/Others □
□ 外国人体格检查记录（复印件）/ Foreigner Physical Examination Record (Photocopy).
□ 来华学习计划/ Study Plan in China.
□ 所发表的文章等/ Articles or Papers Written or Published.   （if you have）
□  护照复印件./ A Photocopy of the Applicant’s Passport

无论申请人是否被录取，上述申请材料恕不退还。
Whether the candidates are accepted or not, all the application materials will not be returned.

申请人保证/I Hereby Affirm That:

1. 申请表中所填写的内容和提供的材料真实无误；
All information and materials 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 are inappropriate to the capacity as a student. 
3、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 in China, I shall abide the rules and regulations of the host university, and concentrate on my studies and researches, and follow the teaching programs arranged by the university.
4.  按照规定参加北京市外国留学生奖学金年度评审；
I shall go through the procedures of the Annual Review of Beijing International Student Scholarship Status as required.
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 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，我愿意接受学校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 host university on suspending, or withdrawing my scholarship, or other 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）