发布时间：2014-10-20
华 北 电 力 大 学
北京市外国留学生奖学金入学奖申请表
North China Electric Power University (NCEPU)
APPLICATION FORM FOR BEIJING GOVERNMENT SCHOLARSHIP
ENTRANCE SCHOLARSHIP
请申请人认真阅读本表第四页的填表说明。请用中文或英文填写此表格。请用电脑打印或用蓝色或黑色钢笔认真书写表格内容。请在所选项框内划‘X’表示。不按规定填写的表格将视作无效。
Please read carefully the important notes on the last page before filling out the form. Please complete the form in Chinese or English. If the form is not filled in on PC, please write legibly in black or blue ink. Please indicate with‘X’in the blank chosen. Any forms that do not follow the notes will be invalid.
1. 申请人情况/Personal Information:
护照用名/Passport Name:
姓/Family Name: ___________________________________________________
名/Given Name: ____________________________________________________
国籍/Nationality: ________________ 护照号码/Passport No.: __________________
出生日期/Date of Birth: 年/Year_______月/Month_______日/Day_______
出生地点/Place of Birth: 国家/Country:_____________ 城市/City:_____________
男/Male：□ 女/Female：□ 已婚/Married：□ 未婚/Single：□ 其它/Other：□
宗教/Religion:______________________________________
当前联系地址/Present Address:___________________________________________________________________
电话/Tel: _____________________ 传真/Fax: _____________________ E-mail: ________________________
永久通信地址/Permanent Address: _______________________________________________________________
电话/Tel: _____________________ 传真/Fax: _____________________ E-mail: ________________________
家庭通信地址/Home Address: _______________________________________________________________
电话/Tel: _____________________ 传真/Fax: _____________________ E-mail: ________________________
2. 本人简历(从高中开始)/Curriculum Vitae（Starting from high school）
单位 时间（年/月——年/月） 主修专业
Previous and Current Education & Employer Years Attended (from/to) Fields of Study
___________________ _____________________ _____________________ ______________________
___________________ _____________________ _____________________ ______________________
___________________ _____________________ _____________________ ______________________
3. 汉语能力/Language Proficiency:
很好/Excellent：□ 好/Good：□ 较好/Fair：□ 差/Poor：□ 不会/None：□
HSK 考试等级或其他类型汉语考试成绩/ Level of HSK test or other certificates which can show your Chinese level:______________________________________________________________________________
4. 来华学习计划/Proposed Study in China:
a).本科生/Bachelor’s Degree Candidate： □
硕士研究生/Master’s Degree Candidate：□
博士研究生/Doctor’s Degree Candidate：□
研究学者/Research Scholar: □
高级进修生/Senior Scholar：□
语言生/Language Student: □
b).申请来华学习专业或研究专题/Subject or Field of Study in China:____________________________________
c)申请专业学习时间/Duration of the Major Study:
自/From：年/Year_________月/Month _________ 至/To：年/Year_________月/Month _________
5. 拟在华学习或研究的详细内容（可另附纸）/ Please Describe the Details of your Study or Research Plan in China (an extra paper can be attached if this space is not enough):
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
6. 曾发表的主要学术论文、著作及作品/Academic Papers, Writing & Art Works Published:
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
7. 推荐您申请北京市政府奖学金的机构或个人/Please Specify the Organization or Person Recommending you for this scholarship _________________________________________________________________________
8. 申请人在华事务担保人或机构/The Emergency Contact Charging Your Case in China:
名称/Name:_______________________________ 电话/Tel:_________________ 传真/Fax:_________________
地址/Address:_________________________________________________________________________________
9. 申请人亲属情况/Family Members of the Applicants:
姓 名 年 龄 职 业
Name Age Employment
配偶/Spouse: __________________________ ______________ _____________________________
父亲/Father : __________________________ ______________ _____________________________
母亲/Mother: __________________________ ______________ _____________________________
•所附材料说明（请在所附附件前划“X”标明）：Materials Attached (Please Indicate with “X” in the Brachet.):
□ 本人最后学历证书复印件/ Diploma of the Most Advanced Studies.
本科/Bachelor’s □ 硕士/Master’s □ 博士/Doctor’s □ 其它/Others □
□ 本人最后学历成绩单复印件/ Transcripts of the Most Advanced Studies.
□ 护照复印件./ A Photocopy of the Applicant’s Passport;
□ 担保书及担保人有效证件的复印件/ Guarantor Form and Photocopy of Guarantor’s ID
□ 无犯罪记录证明./ No Criminal Record Certificate;
□HSK证书复印件/ A photocopy of HSK certificate;
□ 来华学习计划/ Study Plan in China.
□ 两封推荐信/Two Letters of Recommendation.
□ 《外国人体格检查记录》/ Photocopy of Foreigner Physical Examination Form;
□未满18岁的申请者还需提供监护人认证书及监护人公证书./ Notarized Guardian Guarantor Form (Students whose ages are under 18)
•申请人保证/I Hereby Affirm That:
1. 申请表中所填写的内容和提供的材料真实无误；
All information and materials given in this form are true and correct.
2. 在华期间，遵守中国的法律、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合的活动；
During my stay in China, I shall abide by the laws and decrees of the Chinese government, 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. 来华后服从学校的安排，不得无故要求变更学校和所学专业；
I will agree to the arrangements of my institution and specialty of study in Beijing made by the University and will not apply for any changes in these two fields without valid reasons.
4. 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 my study in China, I shall abide the rules and regulations of the host university, and concentrate on my studies and researches, and follow the teaching programs arranged by the university.
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，我愿意接受华北电力大学中止或取消奖学金及其它相应的处罚。
If I am 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 decision of North China Electric Power University on suspending, or withdrawing my scholarship, or other penalties.
申请人签字/Signature of the Applicant:____________________________ 日期/Date:___________
（无此签名，申请无效/The application is invalid without the applicant’s signature）