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南京化工职业技术学院外国留学生来华学习申请表 APPLICATION APPLICA TION FORM FOR INTERNATIONAL STUDENTS TO STUDY AT AT NANJING COLLEGE OF CHEMICAL TECHNOLOGY ( NCCT) 请申请人用中文或英文清楚地填写以下诸项,不能缺项填写,没有的请写 “无”。 . Please fill all the information requested. Handwriting is not acceptable. Please write None if not applicable. 姓 Last/Family Name   照  

姓 名  Name

名 Given Name

(as shown

中  文

!  "

on passport)

In Chinese

 Nationality

Photo

%

'(/ Single %

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&/Female %

)(/Married %

eligion

# /Male ./01

2/Year

3 /Mon

 

0/Date

./地4

67/City

Pla$e o" #irth

!ate o" #irth

89:;地<=>?@A

!5/Co%ntry

67/City

BCDA/Postal Code

Permanent &ddress and 'el No

EF:;地<=>?@A

!5/Co%ntry 

C%rrent address and 'el No

BCDA/Postal Code

您希望我们将邮件寄! #$%&' #$%&'   Please send mails to*

!5/Co%ntry

 >?/'el No

67/City  >?/'el No

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Passport No

alid alid %nt %ntil il

MQRN

STMU名V

cademic !nformation

 Name o" .ome .ome 0niver 0niversity sity

2/Year 3/Mon 0/Date

STWX Maor at .ome 0niversity

YM01 ,ntran$e !ate (yyyy/mm/dd)

STZ[  N%m+er o" o" years enro enrolled lled at hom homee %niversity

\]^_ "hinese language proficienc#

\]MQZ[`a  bc3 a  bMonths o" Chinese St%dy

.S2 de或fghi\]dejk` #and o" .S2 a'est o" Chinese Pro"i$ien$yb`a  bGrade or other $erti"i$ates whi$h $an show yo%r Chinese pro"i$ien$y

1 Spea3ing   不l None %  mn #asi$ %op Intermediate %qr Fl%ent % 4 Listening   不l None %  mn #asi$ %op Intermediate %qr Fl%ent %



5 eading

 

不l None %  mn #asi$ %op Intermediate %qr Fl%ent %

6 7riting

 

不l None %  mn #asi$ %op Intermediate %qr Fl%ent %

生,- Categories of international st!ents"

st/ e8$hange st%dent %  ]u/ Lang%age st%dent %  vw/ short time training st%dent %  Wx/ 9%nior $ollege st%dent % 

yx/ 0ndergrad%ate %

z申请表{B|} 'his appli$ation "orm has to +e mailed to ` 地<`~•€‚7ƒ„…†‡ˆ 625 @‚‰Š‹XŒM ‹XŒMŽ!+Ž Ž!+Ž‘ ‘ BCDA`210048 &dd   ` Inte Intern rnat atio iona nall Educ Educat atio ion n Inst Instit itut ute, e, Nanj Nanjin ing g Coll Colleg ege e of Chem Chemic ical al Techno chnolo logy gy,, Geguan Road, uhe !istrict, Nanjing "iangsu, China, 2#$$%& 'e 'el* l* :;<-4=-=;5>?;;<,:;<-4=-=;5=1??< ,-mail* snhygy@gmail$om

No.6 No.625 25

 

申请MQWX Desired ma$or%

MQ1’ Period o" st%dy* 2 Aear 3 Month “ to 2 Aear 3 Month l”fg]u Pr Pro" o"ii$ie $ien$y in Lang%ages

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>?/GH 'el/Cell No

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Fo Fore reig ign n

!ate o" &rrival (yyyy/mm/dd)*

—˜™š›œ人

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&mergenc# "ontact 'famil#( relati)es( friends( etc.*

 Name*

elationship* elationsh ip*

&ddress*

Mo+ile phone*

"ontact , 'in "hina*

 Name*

elationship* elationsh ip*

&ddress*

Mo+ile phone*

申请人ž` Ÿ

¡¢项 ¡¢项中£ 中£¤¥ ¤¥的™ 的™š¦ š¦§¨ §¨无© 无©的ª 的ª

Ÿ

«中!MQ1[¬ «中!MQ1[¬中!的®¯°M 中!的®¯°MU的±²³´, U的±²³´,不µ¶·”¸¹中 不µ¶·”¸¹中!ºl»¼的,½ !ºl»¼的,½y人¾¿MQÀ y人¾¿MQÀÁ不ÂÄ的ÄÅ Á不ÂÄ的ÄÅ。 。 I here+y a""irm that* 1 &ll the in"ormation in this "orm is tr%e and $orre$t 4 I shall a+ide +y the laws o" China and the reg%lations o" the S$hool and will not parti$ipate in any a$tivities whi$h are deemed to +e adverse to the so$ial order in China and are inappropriate to the $apa$ity as a st%dent

 01`  !ate*

Y

2  M

3  D



申请人Æ名` 

&ppli$antDs Signat%re

Ç`申请人«ÈÉy申请表的ÊZ,请¤s   Ÿ

1O照ËÌJ 

Ÿ

4KLMNžÍËÌJ 

Ÿ

5ÎÏ表   

1 photo$opy o" passport 4 photo$opy o" highest ed%$ation $erti"i$ate 5 #ody $he$3 $erti"i$at $erti"i$atee

6MQЊÑRNžÍËÌJ  

国.

emar3s* 'he appli$ant is reE%ired to s%+mit*

6 photo$opy o" a$ademi$ and wor3 e8perien$e $erti"i$ate

/0

-iews of !nternational &ducation

/!ate  5/Aear  6/Month  3/!ay 12/Signat%re*  34 12/Signat%re* 34/!ate

!nstitute

 789/0 -iews of the principal

12/Signat%re*  34/!ate  5/Aear  6/Month  3/!ay

of the college

z申请表{B|} 'his appli$ation "orm has to +e mailed to ` 地<`~•€‚7ƒ„…†‡ˆ 625 @‚‰Š‹XŒM ‹XŒMŽ!+Ž Ž!+Ž‘ ‘ BCDA`210048 &dd   ` Inte Intern rnat atio iona nall Educ Educat atio ion n Inst Instit itut ute, e, Nanj Nanjin ing g Coll Colleg ege e of Chem Chemic ical al Techno chnolo logy gy,, Geguan Road, uhe !istrict, Nanjing "iangsu, China, 2#$$%& 'e 'el* l* :;<-4=-=;5>?;;<,:;<-4=-=;5=1??< ,-mail* snhygy@gmail$om

No.6 No.625 25

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