ThesisResearchTrainingProgramApplication(2017-2018).doc

Thesis Research Training Program Application (2017-2018) Personal Information Chinese Name Name in Pinyin （Surname, First Name) Photo English Name if You Have One 　 (Y-M-D) Gender Email 　 Cell Phone 　 Postal Code　 Postal Code　 Passport #Passport Expiration Date University Name Matriculation Date (Y-M-D) Year Classification □ Senior 4th year □ Senior 5th year Expected Degree (use √) □ Bachelor of Arts □ Bachelor of Science □ Other Area of Degree Current GPA ___/5.00 （Include 2 decimals） Expected Date of Graduation (Y-M-D) Ranking ___/___ English Proficiency GRE： TOEFL： List three relevant science courses taken during the past year. Course #1 Course #1 Grade Course #2 Course #2 Grade Course #3 Course #3 Grade Do you need to add an additional undergraduate institution? □ Yes □ No Please describe any prior research experience you have participated in (900 characters max). Please explain why you wish to participate in this program (900 characters max). Please describe your scientific interests (900 characters max). Please describe your career goals (900 characters max). Please select the graduate program(s) that you have an interest in. ( Multiple choice, use √) □ Biological and Biomedical Sciences □ Biomedical Engineering and Translational Medicine □ Biophysics and Bioinformatics □ Physics and Applied Physics □ Marine science I certify that all information provided by me in this application, including any supplemental forms, is correct and accurate to the best of my knowledge. I understand that any false information provided could be grounds for termination of my application, or if subsequently enrolled, termination of my studies. In place of your signature, please type your full legal name. _____________ 其他补充信息 学号 姓名 专业 父亲姓名 电 话 工作单位 职 务 母亲姓名 电 话 工作单位 职 务 紧急联系人姓 名 　 手 机 其他需要 说明的事项 （如有） 　　 院系分管学生工作党委书记（签字、盖章）：院系教学院长或主任（签字、盖章）： -