ࡱ> 02+,-./ R8bjbj3}}|N N 83T\)^AWWW((((((($+G.H(q"(WWq)%%%W8W(%(%%%Wp['L#%()0)%.#.%.%"%(($).N  ]: Attachment 1 lWSybf[bVEf[ueQf[3uh APPLICATION FORM FOR INTERNATIONAL STUDENTS STUDY IN HIST (Please type or print) bgq(u T/Name in Passport: Y/Family Name: T/Given Name: -NeY T/Name in Chinese, if applicable: gqGr PhotoVM| Nationality '`+R Gender Queg Date of Birth: yy mm ddQu0Wp Place of Birth: bgqSx Passport No.:  gHeg Valid Until: yy mm ddZZYrQ &]ZZ/Married Marital Status &*gZZ/Single[YeON Religion: gTf[SS_e Highest Education Level and the date obtained or to obtain S_MRf[`NbNLUSMO Currently Institution Enrolled/Employed LN/Occupation: 5uP[N0W@W/E-mail Address:vMRO0W@W0S5u݋/Current Mailing Address &Post Code &Cell Phone No. [^0W@W0S5u݋/Home Address &Post Code & Cell Phone No. SYe`Q/Education Backgroundf[!h Institutions(W!he Years Attendedfrom/to ;NONN Fields of StudykNfNSf[MOfN Certificate and Diploma]\O~S/Employment Record]\OUSMO Employer wbke Timefrom/to NN]\O Work EngagedLR Position3uNN^\`Q/Family Members of the ApplicantsY T/NameLN/ OccupationT|5u݋/Telephone6rN/FatherkN/MotherMvP/SpouseR/Language Proficiency (u_}Y0}Y0N,b NOLċNv^kXeQzz  . H X \ r 翯~kbZOZbZFZbZ;hB>*CJaJo(hB>*CJaJhBCJQJaJo(hBCJaJhBCJaJo(%h*hB5OJQJ\^JaJ o(hBCJaJo(hBCJaJh*5OJQJ\^JaJ o(hB5OJQJ\^JaJ o(h5OJQJ\^JaJ o(3jhgOx5OJQJU\^JaJ mHnHo(uh0R*hgOxCJQJ\aJh0R*hgOxCJ\aJh0R*hCJ\aJ>   $d$Ifa$ $d$Ifa$ $dHa$gd* $dHa$gdgOx       8 Z \ ` b r   R V ^ x  hB>*CJaJhBCJaJo(hB>*CJaJo(hBCJaJhBCJQJaJo(hB>*@CJaJB   \ b yyyyn $$1$Ifa$ d$If}kd$$IfT40Eu$0044 laf4T T offff d$Ifkd$$IfT4AFEu$dM 00    44 laf4TT V `  yyyy d$If}kd$$IfT4N0u$d}044 laf4T  8 x yyyy d$If}kd3$$IfT4L0u$d}044 laf4T " 6 T ` b d v x ^ 46Rdh02:N`f NRnvɬɬɬhB5CJaJhB5CJQJaJo(hB>*CJaJhB>*CJaJo(hAECJaJo(hBCJaJo(hBCJaJhBCJQJaJo(EhAEhAE@KB*CJOJPJQJ^JaJfHo(phq 7 ^ yyy d$If}kd$$IfT4J0u$d}044 laf4T 6}} d$If $d$Ifa$mkd$$IfT4u$$044 laf4ytvATy$Ifkd6$$IfT40u$Q 044 laf4ytvAT $$Ifa$mkd$$IfT40u$$044 laf4ytvAT $$Ifa$mkd$$IfT4:u$$044 laf4ytvATL $d$Ifa$mkd)$$IfT4Tu$$044 laf4ytvATLNTnx $d$Ifa$mkd$$IfT4$u$$044 laf4ytvAT v6>fnVXZp0V`byhB5CJaJo( ho(hCJaJhhCJQJaJhhCJQJaJo(hvACJaJhhvA5CJaJhhvA5CJaJo(hB5CJaJhB5CJQJaJo(hBCJQJaJo(hBCJaJo(hBCJaJ/ _SSSS $d$Ifa$kde$$IfT\ku$  044 laT "$&(*_SSSS $d$Ifa$kd<$$IfT:\ku$  044 laT*,.024_SSSS $d$Ifa$kd $$IfT:\ku$  044 laT46d_S $d$Ifa$kd $$IfT:\ku$  044 laTdfp $d$Ifa$mkd $$IfT4u$$044 laf4ytvAT \SSSS d$IfkdP $$IfT4\ku$  044 laf4T\SSSS d$Ifkd' $$IfT4\ku$  044 laf4T\SSSS d$Ifkd $$IfT4\ku$  044 laf4TX\M$d$Ifa$gdkd $$IfT4\ku$  044 laf4TXZj$d$Ifa$gdmkd$$IfT4u$$044 laf4yt`Tl`QHH d$If$d$Ifa$gd d$IfgdkdG$$IfT4eFz *u$  K 0    44 laf4ytTYM>55 d$If$d$Ifa$gd d$Ifgdkd$$IfT4\z *u$A K 044 laf4yt<4TYM>55 d$If$d$Ifa$gd d$Ifgdkd$$IfT4\z *u$A K 044 laf4yt<4T0YM@ d$If $d$Ifa$kd$$IfT4\z *u$A K 044 laf4yt<4TVXwk $d$Ifa$$d$Ifa$gd<4$d$Ifa$gd<4jkd$$IfT4ou$$044 laf4TXZrpaQ$id$If^ia$$d$Ifa$gd<4$d$Ifa$gd<4kdL$$IfT4o0z u$ 044 laf4yt<4Tdfpgp[ $d$Ifa$ d$If$d$Ifa$gd<4kd$$IfT4o0z u$ 044 laf4yt<4Tbh$&(.BHRX~068b| &(*.6ڨe]hvACJaJEhAEhAE@KB*CJOJPJQJ^JaJfHo(phq hvACJaJo(hJhJCJaJhJhJCJaJo(hI4CJaJh=5CJaJo(hB5CJaJo(h=CJaJo(hB>*CJaJo(hBCJaJh<4CJaJo(h<4CJQJaJo(hBCJaJo(!fh&Vl``U` $$1$Ifa$ $d$Ifa$kd$$IfT4oFz u$A0    44 laf4yt<4TVXw $$1$Ifa$}kd$$IfT40u$ 044 laf4T:<>@{{{ $$1$Ifa$ $d$Ifa$mkd8$$IfT4u$$044 laf4ytvAT@Byn $$1$Ifa$$Ifkd$$IfT40u$ 044 laf4ytvATyn $$1$Ifa$$Ifkd$$IfT40u$ 044 laf4ytvAT(|Fvvvvv $IfgdJkdG$$IfT40' u$ N044 laf4ytvAT6j|~&DF(,<Nhjrt쾳wwwwhJ>*CJaJhJCJaJhJCJQJaJo(hJ>*CJaJo(hJCJaJo(hJhJCJaJo(hJhJCJaJhJhvACJaJEhAEhAE@KB*CJOJPJQJ^JaJfHo(phq hvACJaJo(hvAhvACJaJ.FHvyn $$1$Ifa$$Ifkd$$IfT40' u$ N044 laf4ytvAT,jrnrrr:sZsssvvvvvvvvvvvv d$Ifkd$$IfT40' u$ N044 laf4ytvAT ing Address: T|5u݋/Tel: ~NmbONY T/Name of Financial Guarantor : LN/Occupation : 0W@W/Mailing Address T|5u݋/Tel: 3uNO/ The applicant guarantee3uNO/I Hereby Affirm That 1. NTy-N@bcOv`Q/fw[evAll the information I provided above is true and correct; 2. (WNSg u[-NVvl_0lĉ NNNNUOqS[-NV>yOy^v,N,gNegNSf[`NN N&{Tv;mRDuring my stay in China, I shall abide the laws and decrees of the Chinese government, and will not participate in any activities which are deemed to be adverse to the social order of China and are inappropriate to the capacity as a student. 3. (Wf[g u[f[!hv!h~0!hĉ \͑f[!hvYef[[cDuring my study in China, I shall abide the rules and regulations of the host university, and will concentrate on my studies and researches, and will follow the teaching programs arranged by the university. 4. cĉ[gPO[f[N cgVV NeEe(WNSnYuI 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.3uN~{ T/Signature of the applicant: edk~{ T 3ueHe/The application is invalid without the applicant s signature. eg/Date: yy mm dd&kXhlaNy/Notice for filling the application form 1. N@b gOo`GW(u5ueQ, NMQW[ Nn^[te./All information filled in the Application Form should be typed by means of computers to avoid misunderstanding or mistakes. 2.(WNSNRbONb:gg, {:N(W-NVXQvNXb:gg, NO(W'}%`eNvQS_T|./The guarantors charging your case in China, we will contact them for your case when necessary. 3.3uN(W,g3uhv Te, cN/Please send with this form.  = 1 \* GB3 `$bgq YpSN/One photocopy of your passport  = 2 \* GB3 a$gؚf[Sf/An official certificate of your highest education (or notarized photocopy)  = 3 \* GB3 b$f[`Nb~US/Official transcripts (or notarized photocopy)  = 4 \* GB3 c$~NmbObLX[>kf/ Financial guarantee or bank statement d$erjU_f/Certificate of Non-criminal Record 4.Yg3uPge:N^b^IlHr,g, ы:NIlbeHr,gv^~ǏCgZlQ./If your original certificate is not English or Chinese version, please ask authorized department or your school to translate it into English or Chinese. Tel86-373-3040139 E-mail:  HYPERLINK "mailto:guoji@hist.edu.cn" guoji@hist.edu.cn Address: Eastern Hualan Road Hongqi District Xinxiang City, Henan Province, P. R. 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