姓名

Name

英文姓名（以护照用名为准）

In English (Same as in your Passport)

姓/Family name：

照

片

Photo

名/Given name：

中文姓名 Chinese name

性别Sex

国籍Nationality

婚姻状况Marital Status

宗教信仰Religion

护照号码Passport No.                                                     有效期至/Valid Until _________年______月_______日

Yr.         Mon.        Date

出生日期         _________年______月_______日

Date of Birth                      Yr.         Mon.        Date

出生地                                   国 家                     城市 

Place of Birth                       Country                  City

是否持有在华有效签证？                             签证类型                                         有效期

Do you have valid Visa in China                    Type of visa                                    Valid until

签发单位（学校/公司/中介机构）

Source of Present Visa (Which Shool /Company/Agency? )

最后学历

Highest degree obtained

专业

Major

毕业院校

School of graduation

毕业时间

Time of graduation

目前所在学校或机构

Place of study or work：

职业

Occupation

语言能力，请用“好、一般、不会”评价。 Language proficiency (Good/Little/None)

汉语 Chinese

HSK:     　　      级Level   

英语 English

TOEFL     　　 　  IELTS                 Other               请注明Please specify

其它 Other

留学类别/Categories of International Students I Apply for

□ 汉语生Chinese Language Program                              

□ 本科生/Bachelor’s Program                  

□ 硕士研究生/ Master’s Program   请选择Please choose:1.中文授课Chinese-taught    2. 英文授课  English-taught

□ 博士研究生/PhD program      

拟申请学习的专业

Subject or Field of Study I Apply for

申请学习时间

Duration

自/From:             年/Year      月/Month      日/Day     

至/To:                年/Year      月/Month      日/Day     

费用来源

Financial Support

□ 自费/Self-supporting      □ 项目资助/Funded by projects            

本人联系方式

My Contact Information

电话Tel./Mobile

传真Fax No.

电子邮件 E-mail

录取通知书邮寄地址/Address for correspondence 

(Please inform the CUPB International School for any change of this address)

紧急事务第一联系人

Contact on Emergencies

姓名Name

电话Tel./Mobile

关系、电子邮件 E-mail

家庭成员 Family Members

姓名/Name

年龄/Age

职业/ Occupation

联系电话/Tel

Email

父亲

Father

母亲

Mother

本人简历/Education & Work Experience

申请人保证I hereby affirm that:

（1）上述各项中所提供的情况是真实无误的/All the information I provided above is true and correct;

（2）在校学习期间遵守中国政府的法规和学校的规章和制度/I shall abide by the laws of the Chinese Government and the regulations of China University of Petroleum-Beijing.

（3）保证按时缴纳学费及住宿费/I shall pay tuition fee and accommodation fee on time.

日期/Date                                        申请人签字/Applicant’s signature____________________

申请人在递送本申请表的同时，请提交/ Please offer the following materials with the application form:

（1） 最后学历证明（公证件）/An official certificate of your highest education (notarized version)

（2） 学习成绩单（公证件）/An official transcripts (notarized version)

（3） 推荐信/Two letters of recommendation(original)

（4） 汉语水平证明/英语水平证明Chinese level certificate/ English level certificate

（5） 护照复印件/copy of your passport

无论申请人是否被录取，上述申请材料恕不退还

Whether the candidate is accepted or not, all the application material will not be returned

如需申请学校奖学金，请访问href="http://www.cup.edu.cn/IS/" http://www.cup.edu.cn/IS/或发邮件至admission@cup.edu.cn索取申请表

To apply for University Scholarship, please visit http://www.cup.edu.cn/IS/ for details or contact admission@cup.edu.cn for application form.