江苏大学外国留学生学习申请表-hyit.docVIP

附件4： 淮阴工学院外国留学生学习申请表 APPLICATION FORM FOR FOREIGNERS WISHING TO STUDY IN HUAIYIN INSTITUTE OF TECHNOLOGY 地址: 中国江苏省淮安市清浦区枚乘东路1号淮阴工学院国际教育学院 邮编(Zip Code): 223003 Address: Room 801, School of International Education, Huaiyin Institute of Technology, No.1 Meicheng Road, Qingpu District, Huai’an, Jiangsu Province, 223003, China 电话(Tel): +86-517 +86-517网址(Website): / Email: jinlu1988@ 1.个人情况/Personal statement 护照用名 Full legal Name (Same as in Passport) 姓/Family name: 照片 Photo 3cm×4cm 名/Given name: 中名/Middle name: 中文姓名 In Chinese (if any) 国籍/母语: Nationality/ Native Language / 护照号码/有效期 Passport No. / Validity until: 年yy 月mm 日dd 性别/Gender: (男/Male (女/Female 宗教/Religion: 婚姻状况 Marital Status □ 单身Single □ 已婚Married 出生日期（年/月/日） Date of Birth (Y/M/D) 年/Year 月/Month 日/Day 出生地点 Place of Birth 城市/州/省/City/State/Province: 特长爱好 Special Skills or Interest 国家/Country: 永久通讯地址/Permanent Home Address: 电话/Tel: 传真/Fax: Email: 目前通讯地址/Current Mailing Address If Different from Permanent Address: 电话/Tel: 传真/Fax: Email: 2. 语言能力和学习计划/Language Proficiency and Study Plan 语言能力（请自评“很好/好/一般”）/ Language Proficiency (Please evaluate your ability as “Excellent/Good/Fair”) 读/reading 说/speaking 写/writing 中文/Chinese 英语/English 来华留学申请类别 Categories of Foreign Students ( 本科生/Undergraduate Student ( 硕士研究生/Master’s Candidate ( 语言进修生/Chinese Language Student ( 短期进修生/Short-term Visiting Student(less than 6 months) ( 长期进修生/Long-term Visiting Student 学习专业或研究课题（请参见招生专业目录） Field of Study, Please Refer to the Catalog of Programs 学习时间/Duration of study 从/From 到/to 在华学习或研究的详细计划，请另附页。 Statement of your study or research in Jiangsu University, using a separate sheet. 3. 本人学历(从高中开始)/Educational Background (Starting from High School) 校名/School Name 地点/Location 专业/Major 时间/Dates