复旦大学交流学生入学申请表

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1、复旦大学交流学生入学申请表ApplicationFormforExchangeStudentsWishingtoStudyatFudanUniversity该栏由学校填写/Thisistobefilledoutbytheuniversity.类别专业汉语费用申请编号请申请人用中文或英文清楚地填写以下诸项，并打印。不接受手写。不能缺项填写，没有的请写“无”。和护照复印件一起递交。Pleaseprintalltheinformationrequested.Handwritingisnotacceptable.PleasewriteNoneifnotapplica

2、ble.Submitthisformtogetherwithphotocopyofyourvalidpassportphotopage.护照名（英语）FullNamewithMiddleInitialinEnglishaccordingyourpassport照片PHOTO中文名ChineseName必须填写，不超过6个汉字。Thismustbefilled.(innomorethansixcharacters)国籍Countryofcitizenship性别Gender□男Male□女Female出生日期Dateofbirth年/yy月/mm日/dd出生地

3、点Placeofbirth护照号码PassportNo.护照有效期PassportValiduntil年/yy月/mm日/dd婚姻状况MaritalStatus宗教信仰Religion职业Occupation工作单位Univ./Employer手机Cellphone电子邮件E-mail家庭住址HomeAddress邮政编码ZipCode电话/传真Tel/Fax通信地址Mailingaddress收件人Receiver邮政编码ZipCode电话/传真Tel/Fax推荐单位Recommendedby联系人Contactperson联系地址Address电话/传真

4、Tel/Fax３学习经历（高中起填写）Educationalbackground（FromHighSchool）学校名称Institutions在校时间Yearsattended(from/to)主修专业Fieldofstudy所获文凭Diplomareceived——————————语言能力，请用“好，一般，不会”评价。Languageproficiency（Good/Average/None）汉语ChineseHSK：_______级;新HSK(□初级、□中级、□高级)：__________;BCT：____________英语EnglishTOEFL(

5、score)________；GMAT_________；GRE_________；IELTS____________其他Other学习计划StudyPlanatFudan(pleaseclickwhatyouplantostudy)Exchangestudentsaremostlynon-degreevisitingstudents.FudanUniversitymaytakedegreeexchangestudentsfollowingthebilateralagreementbetweenFudanUniversityandyourhomeinstit

6、ution.申请类别Category专业或专题Subjectorfieldofstudy指导教师Advisor学位生DEGREE□硕士研究生DoubleMastercandidate专业/Major：研究方向Researchfield：□本科生DoubleBachelorcandidate专业/Major：非学位生NONDEGREE□高级进修生SeniorAdvancedStudent(=post-graduatelevel)专业Major：□普通进修生GeneralAdvancedStudent(=Undergraduatelevel)专业Major：□语

7、言进修生Languagestudent专业Major：汉语/Chineselanguage学习时间Durationofstudy自/From年/yy月/mm日/dd至/To年/yy月/mm日/dd３经费来源FinancialSupport□自费Self-support保证人姓名Guarantor'sname：与申请人关系Relationshipwiththeapplicant：地址Address：电话/传真Tel/fax：保证人签名Guarantor'ssignature：□校际交换Universityexchange学校名称Universityname：联

8、系人Contactperson：工作部门Depart