西安市“中亚五国”留学生教育培训计划项目专项奖学金申请表.docx

西安市中亚五国”留学生教育培训计划项目专项奖学金申请表Application Form for the HFive Central Asian Countries1' International StudentEducation and Training Program scholarship in Xi'an护照用名 /Name in passport姓/Family name中文名/Chinese name：照片 Photograph名/Given name国籍 /Nationality护照号码 /Passport No.出生日期 /Date of birth年月日/year /month /date男/Male口女/Female已婚/Married 口未婚/Single出生地点 /Place of birth宗教 /Religion最后学历/ Highest academic qualification职业或身份 /Occupation工作或学习单位/Study or work place母语/Native language永久通讯地址/Address：电话/Tel：传真/Fax：E-mail ：汉语/英语水平/ Chinese/English language proficiency Chinese： None HSK Level others English： None IELTS TOEFL口 others申请学习类别/Applying Program：1 .层次/Program type：口本科/Bachelor口专科/Junior College2 .专业/Major： 3 .学习时间/Study duration 从/from年/Y月/M 日/D 至!|/to年/Y月/M日/D4 .奖学金种类/Scholarship type：口一类/Type A二类/ Type B家庭主要成员/Family members姓名/ Name关系/ Relation电话和传真/ Tel. & Fax工作单位/ Workplace 职位/ Post本人简历(从高中开始)/Curriculum vitae (Starting from senior middle school)年/Y 月 /M 至U/to 年/Y 月/M month Institution Position例如：2012.062014. 06 xx middle school student我愿意到西安学习，在校学习期间保证做到下列各项：1 .遵守中华人民共和国法律。2 .遵守学校的各项规章制度，努力学习。3 .按时缴纳学校规定的学生应该缴纳的各项费用。4 .上述各项中填写的内容是真实无误的。I am willing to study in Xi' an, and pledge the following terms during my study：1. I will abide by the laws of the People' s Republic of China.2. I will abide by the rules and regulations of the school and study hard.3. I will pay all expenses on time.4. All the information in this form is true and correct.学生本人签字/Applicants signature：日期/Date：