志奋领申请表.docVIP

Chevening Scholarships Application form – CHEV 1 PHOTOGRAPHPlease complete all parts of this form in black ink or typescript andattach a recent photograph of yourself. PHOTOGRAPH A note at the end of this form explains who will see the informationyou supply to us, and why. Part A Personal details Family name (as in your passport) (Chinese and pinyin) FORMTEXT Given name (Chinese and pinyin) FORMTEXT Title FORMCHECKBOX Mr FORMCHECKBOX Mrs FORMCHECKBOX Miss FORMCHECKBOX Ms FORMCHECKBOX Dr Sex FORMCHECKBOX Male FORMCHECKBOX Female Place of birth FORMTEXT Date of birth FORMTEXT Status FORMCHECKBOX Single FORMCHECKBOX Married FORMCHECKBOX Divorced FORMCHECKBOX Widowed Nationality (Minzu) FORMTEXT Number of children (if applicable) FORMTEXT Will members of your family accompany you to the UK? If yes, please specify who they are and state how you propose to meet their expenses. Under the Chevening Scholarships scheme, we cannot pay married or child allowances; any stipend you receive is intended to cover your expenses only. FORMTEXT  Your address in Chinese and English ; where we should send letters Name, address of next of kin or person in your home country who should be contacted in the event of an emergency (please state relationship). FORMTEXT FORMTEXT Your contact details Business E-mail FORMTEXT Private E-mail FORMTEXT Business Telephone FORMTEXT Home telephone FORMTEXT Mobile number FORMTEXT Emergency contact No.of next kin FORMTEXT FORMCHECKBOX Please tick this box to confirm that you have told your emergency contact that you have given us their details. Where are you currently working or studying? FORMTEXT If you are currently working, please provide details of your post, grade and main duties, including any management responsibilities. Please draw an organogram of your department and highlight where you are within one hierarchy. Brief introduction to your organisation and department : F