湖北省教育厅 表二.doc

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1、湖北省教育厅HUBEIPROVINCIALDEPARTMENTOFEDUCATION表二中国湖北省武汉市武昌区洪山路8号4300718HONGSHANROADWUHAN，HUBEI，P.R.China430071Tel:0086-27-87328141E-mail:fao@e21.edu.cnFax:0086-27-87328047Http://www.hbe.gov.cn/湖北省外国留学生奖学金申请表APPLICATIONFORMFORHUBEIPROVINCIALINTERNATIONALSTUDENTSCHOLARSHIP(此表供已在申请学校就读的申请人使用Appl

2、icableforapplicantsbeingadmittedtouniversitiesinHubei)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。PleasecompletetheforminChineseorEnglish.IftheformisnotfilledinonPC,pleasewritelegiblyinblackorblueink.Pleaseindicatewith‘X’intheblankchosen.Anyformsthatdonotfollowthenot

3、eswillbeinvalid.1.申请人情况/PersonalInformation:护照用名/PassportName:姓/FamilyName:_______________________名/GivenName:__________________________国籍/Nationality:__________________护照号码/PassportNo.:______________________出生日期/DateofBirth:年/Year___________月/Month___________日/Day______________出生地点/Place

4、ofBirth:国家/Country:_________________城市/City:_______________男/Male□女/Female□已婚/Married□未婚/Single□其它/Other□母语/NativeLanguage:__________________________宗教/Religion:___________________当前联系地址/PresentAddress:________________________________________________________________电话/Tel:_______________传

5、真/Fax:_______________E-mail:______________________永久通信地址/PermanentAddress:_____________________________________________________________2.受教育情况/EducationBackground:学校Institutions在校时间YearsAttended(from/to)主修专业FieldsofStudy_____________________________________________________________________

6、_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________最后学历及学位/MostAdvancedStudies：博士/Doctor’s□硕士/Master’

7、s□本科/Bachelor’s□高中r’s□3.工作经历/EmploymentRecord:工作单位Employer起止时间Time(from/to)从事工作WorkEngaged职务及职称PostsHeld__________________________________________________________________________________________________________________________________________________________________