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Application Form for International Students

Date:2022-03-14

广西电力职业技术学院国际学生申请表

Guangxi Electrical Polytechnic Institute

Application Form for International Students


外文·

Surname  

外文·

Given Name  

贴相片处

paste

photo

中文姓名

Chinese Name  

国籍

Nationality

/Male  

/Female

未婚/Single  

已婚/Married

宗教信仰

Religion


职业

Occupation


出生日期/Date of Birth

 /Year      /Month        /Day

出生地点/ Place of Birth

国家/Country:  城市/City

护照号码

Passport No.


护照有效期

Date of Expiration

/Year    /Month    /Day

最后学历

Highest Education


联系电话

Mobile Number


邮箱

E-mail


申请学习专业

Major Applied for in GXEPI


申请学习时间

Duration of Study

/From: /Year /Month  /To: /Year /Month

拟到校学习日期

Proposed Arrival Date at GXEPI

______/Year  ______/Month  _____ /Day

永久通讯地址及电话号码

Permanent Address and Telephone Number

国家/County 城市/City_______________

街道/Streets

邮政编码/Postal Code 电话/Cell.No.

目前通讯地址及电话号码

Current address and Telephone Number

国家/County __________     城市/City_____________________

街道/Streets ______________________________________________________

邮政编码/Postal Code 电话/Cell.No.__________________

紧急联系人(可以是父母或亲戚朋友,国籍不限)

Emergency contact during your stay at GXEPI (Contact person can be a parent or relative of applicants)

姓名/Name 与申请人关系/Relationship to the applicant

电话/Tel 手机/Cell

在华事务联系人(或监护人)/ Contact Personor Guardianin China

姓名/Name 与申请人关系/Relationship to the applicant_____

电话/Tel 手机/Cell


教育背景/Education Background

校名

School






在学时间

Dates of Study


主修专业

Major Fields of Study


取得证书

Qualifications


工作经历/Work Experience

工作时间

Date




工作地点及单位

Place

职位

Position

经费来源/Source of Finance

□自费

Self-support

担保人姓名/Name of Financial Sponsor:  电话/传真Tel/Fax

地址/Address

□校际交换

University exchange

学校名称/University name:  电话/传真Tel/Fax:  

联系人/Contact person:  邮箱/E-mail

你所具备的汉语基础 Describe Your Backgrounds of Chinese Language

听力Listening:  □很好/Excellent    □好/Good     □较好/Average □差/Poor    □不会/None

会话Speaking:  □很好/Excellent    □好/Good     □较好/Average □差/Poor    □不会/None

阅读 Reading:  □很好/Excellent    □好/Good     □较好/Average □差/Poor    □不会/None

写作 Writing:  □很好/Excellent    □好/Good     □较好/Average □差/Poor    □不会/None

HSK等级/Level of HSK 学校汉语测试等级/ Chinese Level of GXEPI test

申请人是否曾在华学习或任职 Have you ever studied or worked in China?

/Yes : 学习或任职单位/School or Employer:

在华时间/Time in China: /From: /Year /Month /To: /Year /Month

/No

申请人亲属情况/ Family Members of the Applicants:

姓名/Name        年龄/Age  职业/Employment    电话/Phone


配偶/Spouse:  

父亲/Father:  

母亲/Mother:  

兄弟/Brothers :

姐妹/Sisters:  

其他需要说明的情况/Further Information






申请人保证 I hereby affirm that

1. 上述各项中所提供的情况是真实无误的。

All the information filled in this form is true and correct.

2. 在华学习期间,遵守中国法律、法规,不从事任何危害中国社会秩序的、与本人来华学习身份不符的活动。During my stay in China, I shall abide by the laws and decrees of the Chinese government and school regulations, and will not participate in any activities in China which are deemed to be adverse to the social order of China and are inappropriate to the capacity as a student.

3. 在学期间,遵守学校的校纪、校规,全力投入学习和研究工作,尊重学校的教学安排。

During the study in China, I shall abide by the rules and regulations of the host university, and concentrate on my studies and researches, and follow the teaching programs arranged by the university.

4. 按规定期限修完学业,按期回国,不能无故在华滞留。

I shall return to my home country as soon as I complete my scheduled program in China, and will not extend my stay without valid reasons.

5. 如违反上述保证而受到中国法律、法规或校纪、校规的惩处,我愿意接受相应的处罚。

If I judged by the Chinese laws and decrees and the rules and regulations of the university as having violated any of the above, I will not lodge any appeal against the penalties.

6. 按照学校规定在注册时缴纳学费、住宿费、报名费等其他费用并自觉在中国境内购买留学生综合保险。中途辍学或被开除学籍者,已交付的相关费用概不退还。

I shall pay the tuition fee, accommodation fee, registration fee and any other fees and buy the Comprehensive Insurance for Foreigner Staying in China by myself before/when I register. I notice that no fees which I paid before will be refunded if I drop off or be dismissed from school.


申请人签字/Applicant’s Signature             日期: Date: /YY       /MM    /DD

备注 Note

1. 申请时请寄来:①学位证书/毕业证书复印件。②在华逗留三个月以上者提供正式医院出具的有效健康证明(自签发之日起半年内有效)。③护照复印件。无犯罪记录证明

Please enclose:Two copies of transcripts. Those to stay in China 3 months or above should provide a statement of health and physical condition(6 months validity from the date of issue) from a medical doctor on his/her letterhead, when you mail this form. Photocopy of your passport.Certificate of No Criminal Record.

2. 来校注册时需交近期护照规格照片十张。

Ten most recent passport sized photos will be needed at registration.

3. 以上表格必须认真填写,每项内容必须填写,没有的内容请写“无”;表格内容不全者将不予受理。

The form must be full filled out carefully without any omission. If your situation does not fit in, please write None at the space. The incomplete form will not be accepted.


填好本表后请按下列地址邮寄  Please return the completed form to the address below:

中国

广西南宁

玉洞大道109号

广西电力职业技术学院国际教育学院

School of International Education

Guangxi Electrical Polytechnic Institute

109 Yudong Avenue, Nanning

Guangxi

P. R. China


Tel: +86-771-2212983

+86-15977751409

Email: gxdlxydwb@