外国专家证请表.doc

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1、外国专家证申请表ForeignExpertsCertificateApplicationRecord申请号：专家类别：□经济技术类□科教文卫类workingfield：EconomicsandTechnologyCulturalandEducationDONOTWRITEINTHISSPACE37*37PHOTOGluephotohere请勿填写此处2寸免冠照片请用胶水将照片附于此处姓（如护照所示）：SURNAME(AsinPassport)名（如护照所示）：FIRSTANDMIDDLENAME(AsinPassport)其它曾用姓氏（外文）：OTHERSURNAMEUSED(Ma

2、iden,Religious,Professional,Aliases)其它名字（外文）：OTHERFIRSTANDMIDDLENAMESUSED出生年月日：国籍：护照号码：DATEOFBIRTH(yy-mm-dd)NATIONALITYPASSPORTNUMBER译名：性别:□男□女CHINESENAMESEXMALEFEMALE出生地（外文）：国家省份城市PLACEOFBIRTH(Country-State-/Province-City)住址(国家、省、市、街道、单元号码、邮编,外文填写)：HOMEADDRESSINCOUNTRYOFORIGIN(Includeapartmen

3、tNumber,street,city,stateorprovince,postalcode,andcountry)住址电话：电子信箱地址：HOMETELEPHONENUMBERE-MAILADDRESS最高学历：EDUCATIONBACKGROUND现工作单位CURRENTWORKUNIT聘用单位名称、地址：NAMEANDSTREETADDRESSOFEMPLOYERINCHINA(Postalboxnumberunacceptable)聘用单位联系人地址、电话（手机）、传真：NAMEANDSTREETADDRESSOFEMPLOYERINCHINATELEPHONEANDFAX

4、NUMBERANDCONTACTPERSON(Postalboxnumberunacceptable)在中国拟聘职务：POSITIONINCHINA在中国拟承担任务：YOURWORKINGMISSIONSINCHINA拟抵中国时间：WHENWILLYOUARRIVEINCHINA?预计停留时间：HOWLONGDOYOUINTENTTOSTAYINCHINA?列出所有曾经授予你护照的国家：LISTALLCOUNTRESTHATHAVEEVERISSUEDYOUAPASSPORT你是否曾经在中国工作过？□是□否HAVEYOUEVERWORKEDINCHINA?YesNo何时?何地?WH

5、ENWHERE你是否曾经申请过外国专家来华工作许可？□是□否HAVEYOUEVERAPPLIEDANYOTHERFOREIGNEXPERTSWORKINGPERMITINCHINAYesNo何时?何地?WHENWHERE随行家属情况ACCOMPANYINGFAMILYMEMBER123姓名（如护照所示）NAME姓氏SURNAME名称FIRSTANDMIDDLENAME与申请人关系RELATIONSHIPTOTHEAPPLICANT国籍NATIONALITY护照号码PASSPORTNUMBER证件代办人姓名：手机号码：SIGNATUREOFTHESPONSOROFAPPLICANTT

6、ELEPHONENUMBEROFTHESPONSOROFAPPLICANT聘用单位领导签字日期：年月日申请单位盖章申请者请勿填写以下内容申请收到日期：年月日办理日期：年月日办理人：批准人：有效期至：年月日单位盖章