同济大学短期外国留学生入学申请表.doc

同济大学短期外国留学生入学申请表 Application Form for Short-Term International Students at Tongji University 姓名Name in full 性别Gender 照片 Photo 国籍Nationality 护照号码Passport No. 护照有效期Valid until 出生日期Date of Birth 出生地点Place of Birth 健康状况Health Status 婚否 Marital Status 宗教信仰Religion 通讯地址Mailing Address 电话号码 Phone No. 电子邮件E-mail 本人学历Educational Background 现有汉语水平Current Chinese Level 曾学习过汉语？Ever studied Chinese? 是Yes 否No 已经学习过_________个月汉语 I have studied _________ months of Chinese. 已经达到HSK_______级 I have obtained ______ band of HSK (Test of Chinese Proficiency). 已学汉语教材I have studied the following Chinese textbooks: 现有语言能力Language Proficiency 语言Language 出众Excellent 良好Good 中等Intermediate 不会Beginner Chinese _____________ ____________ ______________ ____________ English _____________ ____________ ______________ ____________ Others ( ) _____________ ____________ ______________ ____________ 留学期限Intended Period of Study (from ____________________________ to _________________________________ ) 预定学校宿舍？Need residence on campus? 是Yes_________ 否No_________ 预定住宿期间 从 月 日 到 月 日 Period of Reservation from to 工作或学习单位 Employer or Educational Institution 紧急联络人Emergency Contact 姓名Name ________________________________________________________________ 与本人关系Relationship ____________________________________________________ 电话Telephone ____________________________________________________________ 地址Address ______________________________________________________________ 申请人保证： 上述各项中填写的内容是真实无误的。 在同济大学学习期间，遵守中国的法律和学校的规章制度。 I hereby affirm that: All the above information is true and correct. I shall abide by Chinese laws and the regulations of Tongji University. 申请人签名： 申请日期： Applicants Signature: Date of Application: 备注Additional Information 预祝您申请成功！ We wi