百人会英才奖-中山大学研究生院.DOC

Committee of 100 Leadership Scholarship Application Form (Year 2014-2015) 百人会英才奖申请表 （201-2015学年） 仅限研究生 For Graduate Students Only 所有资料请用英文填写 All information should be completed in Chinese or English. 如资料填写不完整，申请可能。 All sections of this form should be completed, otherwise applicant may be disqualified. 申请截止日期为201年月日。 must be submitted before May 15th, 2015. 一、申请人基本情况/Personal Information 姓名 Full Name 拼音Name in Pinyin 生日Birth Date 年 月 Y M D 性別 Sex 民族Ethnicethnic ethnicethnic 婚否 Marital Status 家庭人均年收入 Annual Household Income Per Capita 收入来源Income Source 电邮Email Mobile 电话 T 当前通信地址 Present Address 永久通信地址 Permanent Address 二、学业信息/ Academic Information 现就读 Current 大学 University 学院 School 系 Department专业Major 攻读学位 Degree Expected 就读时间Duration 自 From To 曾就读 Previous 大学 University 学院 School 系 Department 专业Major 所获学位 Degree Earned 就读时间Duration 自 From To 曾就读 Previous 大学 University 学院 School 系 Department 专业Major 所获学位 Degree Earned 就读时间Duration 自 From To  三、申请英才奖的相关材料 / Supporting Information 在读期间成绩Academic Performance of Graduate Study 在读期间成绩单（请另附）T Transcript. (Please attach it to the application) 最一学年课程平均成绩 及年级排名 Averaged Score and Ranking in the Class for Most Recent Year 曾获奖项（列出不超过7个）/ Honors and awards (List only seven) Please describe the methodology of selection and significance of each honor and award. 3、 最近三年的志愿者或社会公益活动经历/ Volunteer and Community Service Experience in last three years. Please describe the social impact of the service and your contribution. 四、大学推荐意见/ Recommendation from Nominator 请对申请人领导能力志愿者经历社会活动表现说明您的推荐理由800字为宜。Please describe why the student was nominated for this award, emphasizing in the area of leadership and volunteer/community service experience. Word limit 800 words in Chinese; 500 word limit in English. 大学推荐人/Contact Information 姓名/Name: 职务/Position 电话/Telephone 手机/Mobile 电邮/Email 签/Signature: 日期/Date: 五、推荐人(推荐人不能与大