出生地点/Place   of Birth (Town or city)

出生日期/Date   of Birth

(Day/Mouth/Year)

工作或学习单位/School You Graduated For or   Institution You Work For

国籍/Nationality

性别/Gender

婚否/Marital   Status

宗教/Religion

母语/Native   Language

通用语言/Common   Language

护照号码/Passport   No.

护照有效期Passport   Validity

起/Date   of Issue:

止/Date   of Expiry:

签证类型/Visa   Type

签证有效期   Visa Validity

手机/Cell-phone   :

(Country Code)+

最高学历/Highest   Diploma

职业/Occupation   (if applicable)Student

电子邮件/E-mail

爱好/Hobbies

体育类   /Sports __ ______音乐类   /Music ____ ___ 舞蹈类 /Dances __________

详细的永久居住地址 / Permanent Residence Address in   details

在华居住地址(精确到房号）/ Residence Address in China（detailed   to Room Number）

语言能力   / Language Proficiency

汉语能力

Chinese Proficiency

很好/Excellent( ) 好/Good ( ) 较好/Fair( ) 差/Poor( ) 不会/None( No )

老(新)HSK证书___级___分/Old(New)HSK   Certificate, Level _______ Marks________

英语能力

English Proficiency

英语/English:很好/Excellent( ) 好/Good ( ) 较好/Fair( ) 差/Poor( ) 不会/None( )

雅思考试成绩/IELTS   Marks (if available) __________

托福考试成绩/TOEFL   Marks (if available) _________

教育背景（从初中起）/ Educational Background (From Junior   School)

在校期间   (From/To)

学校   (Institutions)

所获学历   (Diploma/Obtained)

本人工作经历   / Employment Record (if applicable)

起止时间   (From/To)

工作单位   (Employer)

职位及职称   (Posts Held)

留学西科大计划 / Study Plan in XUST

学生类别

Student Status

学历生   / Degree Student

非学历生项目   / Non-degree Student

本科生   / Undergraduate ( )

硕士生   / Postgraduate ( )

博士生   / PhD ( )

预科生Chinese   Language Student

进修生/Advanced   Student  ( )

Short- term≤6 months ( )

Long-term＞   6 months ( )

研究学者/Scholar ( )

最高学历专业

Highest Degree Major

申请专业

Applied Major

学习期限

Duration

自/from:年/Year____月/Month____至/to:   年/Year____月/Month_____

经费来源

Financial Resource

学校资助/University（ ） 家庭资助/Family (  )  团体资助/Organization( )

亲属情况/Family   Members

姓名/Name

职业/Occupation

电话/Tel.

邮箱/E-mail

父亲/Father

母亲/Mother

配偶/Spouse

在西安科技大学学习期间住宿房间类型 Options of Accommodation at   XUST

□ 单人间 Single-bed Room (CNY 6000 per person per year)

□ 双人间 Double-bed Room ( CNY 3000 per person per year)

□ 校外居住 Live out of campus

在华事务担保人/The Guarantor In Charging of Your   Case in China

姓名/Name

工作单位/Organization

电话/Tel.

邮箱/E-mail

联系地址/Address

国际学生保证

申请表中所填写的内容和提供的材料真实无误。

All the information given in this form   is true and correct.

在华期间，遵守中国的法律法规，不从事任何危害中国秩序的、与本人来华学习身份不相符的活动。

During my stay in China, I shall abide   by the laws and decrees of the Chinese Government, and will not participate   in any activities, which are deemed to the social order in China and   inappropriate to the capacity as a scholar or student.

在学期间，遵守学校的校规校纪，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   observe the rules and regulations of the university, and will concentrate on   my studies and researches, and will following the teaching programs made by   the university.

日期/Date:   ____/____/_____ 签字/   Signature: _______

◎若无签字，则视为无效申请/The application is invalid without   the signature