研究生交换项目申请表0.docVIP

Peking University 研究生交换项目申请表 Application for Graduate Student Exchange Program 1. 交换项目信息 Exchange Program Information 项目名称 Program ________________________________________________________ 交换学校 _______________________________________________________ 交换时间 Exchange Duration (dd/mm/yy) ____________________________________________ 交换层级 Exchange Level □ 博士研究生 Phd Student □ 希望在北京大学学习院系及专业 Expected Major at Peking University ________________________________________________________________________________ 经费来源 Source of Funding 奖学金 □ 交换项目 □ 自费 □ 其他 □ Scholarship Exchange Program Self-Supporting Others 2. 个人资料 Personal Information 姓名 ______________ ______________ _____________ Name Family Name First Name Middle Name 出生日期 Date of Birth (dd/mm/yy) ________________________ 性別 Gender 男 Male □ 女 Female□ 婚姻状况 Marital Status 单身Single □ 已婚Married □ 国籍/地区 Nationality __________________________________________________ 护照号 Passport Number Date of Expiration ______________________________________ 港澳居民往来内地通行证/台湾居民往来大陆通行证号码 Number of the Pass of Hong Kong and Macao /Taiwan Residents for Coming to and Returning from the Mainland of China__________________ 通讯地址Mailing Address ______________________________________________________ E-mail _____________________________________________________________________ 电话号码 Phone _____________ 手机号码 Mobile _____________ 传真号码Fax _______________ 紧急情况联系人及电话 Emergency Linkman Tel _________________________________________ 3 教育 Education Background 本科教育 Undergraduate Education 就读院校 University ___________________________________________________ 就读专业 ___________________________________________________ 所获学位 Degree Awarded ___________________________________________________ 研究生教育 Graduate Education 当前就读院系Current Institute ___________________________________________________ 年级 Grade ___________________________________________________专业 Majo