学生类别（请选择）

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1、学生类别(请选择)StudentCategory(PleaseTick√)¨硕士研究生/Master’sStudent¨博士研究生/DoctoralStudent¨普通进修生/VisitingStudent¨高级进修生/SeniorVisitingStudent机构代码(AgencyNumber)：80001中国北京中关村东路80号，邮政编码：100190InternationalStudentsOffice,UniversityofChineseAcademyofSciencesNo.80,ZhongguancunEastRd.,Beijing100190,China电话/Tel:+8

2、6-10-82672900传真/Fax:+86-10-82672900邮箱/E-mail:iso@ucas.ac.cn网站/Website:http://www.ucas.ac.cn国际学生入学申请表ADMISSIONAPPLICATIONFORMFORINTERNATIONALSTUDENTS护照照片PassportPhoto第一部分/PartI请申请人认真阅读本表最后一页的注意事项，准确无误填写下列各项。Pleasecarefullyreadtheinstructionsgivenattheendandfillintheformwithoutanymistakes1.护照用名/Pas

3、sportName:Writtenincapitalletters姓/Surname名/GivenNames2.中文姓名/ChineseName(Ifany):3.性别/Sex:¨男/Male,¨女/Female4.出生日期/DateofBirth:5.出生地点/PlaceofBirth:,年/Year月/Month日/Day州或省/StateorProvince国家/Country6.国籍/Nationality:7.护照号码/PassportNo.:有效期/ExpiryDate年/Year月/Month日/Day8.婚姻状况/MaritalStatus:¨未婚/Single¨已婚/M

4、arriage其他/Other9.职业/Occupation:10.最后学历/HighestDiplomaObtained:获得时间/ObtainingTime11.身高/Height:cm年/Year月/Month12.本族语/NativeLanguage:13.宗教信仰/ReligiousBelief(Optional)14.永久通讯地址/PermanentAddressWrittenincapitalletters电话/Tel:传真/Fax:电子邮件/Email:15.目前通讯地址/CurrentCorrespondenceAddressifdifferentfrompermane

5、ntaddress,pleasespecify若被录取，此地址为录取材料的邮寄地址。/Thisaddressisvalidforreceivingyouradmissionpackageifyouhavebeenadmitted.:Writtenincapitalletters电话/Tel:传真/Fax:电子邮件/Email:16.在中国科学院大学学习计划/ProposedStudyPlanatUniversityofChineseAcademyofSciences(UCAS)(1)学生类别/StudentCategory:¨硕士研究生/Master’sStudent,¨博士研究生/Ph

6、DStudent¨普通进修生/VisitingStudent,¨高级进修生/SeniorVisitingStudent(2)学习专业/ResearchSubjectorField:(3)授课语言/ExpectedTeachingLanguage:¨英语/English,¨汉语/Chinese(4)学习单位/HostinstituteorFaculty:(5)学习期限/Expecteddurationofstudy:自/From年/Year月/Month至/To年/Year月/Month(6)研究计划/ResearchProposal:请另附纸详细陈述/Pleasedescribeyour

7、researchproposalindetailsonadditionalsheet.17.受教育情况/EducationalBackground:学校地点在校时间主修专业所获证书、学位InstitutionLocationYearsAttended(from/to)FieldofStudyDiplomaObtainedortoObtain18.工作经历/EmploymentRecord工作单位起止时间从事工作职务及职称Employ