2010－2011年度哈佛燕京访问学者项目申请表格（英文）.docVIP

Visiting Scholars Program HARVARD-YENCHING INSTITUTE (2010-2011) Return to: Deadline for Application: June 15, 2009 Program Office Harvard-Yenching Institute Phone: 617-495-0702 Vanserg Hall, Suite 20 Fax: 617-496-7206 25 Francis Avenue Email: ruohong_li@harvard.edu Cambridge, USA (Please type or write in black ink) PART ONE (to be completed by faculty member applying) Family Name __________________________ Given Name _________________________________________ 漢 字 ____________________________ Age ___________ Gender (please circle): Male / Female 2. Place of Birth: City ___________ Country ________________ Date of Birth _______________________________ 3. Citizenship (nation from which passport is obtained) _____________________________________________________ 4. Present title as faculty member _____________________________________________________________________ 5. University: Department: 6. Office address____________________________________________________________________________________ H O 7. Telephone 8. Fax: 9. Email: 10. Best Mailing Address: ____________________________________________________________________________ _______________________________________________________________________________________________ 11. Colleges Universities Attended Principal subject Dates of study Degree year awarded ____________________________ ______________ _________________ __________________ ____________________________ ______________ _________________ __________________ ____________________________ ______________ _________________ __________________ ____________________________ ______________ _________________ ___________________ 12. Names, addresses, phone/fax numbers and email addresses of individuals from whom you are requesting letters of recommendation. Three (3) are required, one of which must be from your adviser or the person most familiar