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姓 Family Name:                                名Given Name:



国籍Nationality:            性别Sex:        护照号码Passport No.:

出生日期Date of Birth:                       出生地点Place of Birth:

健康状况Health Status:      婚否 Marital Status:        宗教信仰Religion:

本国通讯地址HOME Address:                                 

电话号码 Phone No.


本人最高学历Highest Academic Degree Obtained:

本人学习(工作)简历Working Biographical Notes:

现有汉语水平Present Proficiency of Chinese

学习过汉语 Learned Chinese:   是 Yes□   否No □

已经学习过   个月汉语                              months of Chinese learning

已经达到HSK   级                                  band of HSK (Test of Chinese Proficiency) achieved

留学类别Categories of International Students:

①本科生Undergraduate □                        ②硕士研究生Master's candidate □

③博士研究生Doctoral candidate □               ④汉语进修生Chinese Language Learner □

留学期限Duration of study (from/to)

申请学习专业Applying for(specialty):

经费来源 Source of Funding:  奖学金 / Scholarship □;  自费 / Self-supporting□;   其他/Other □
经济担保人或机构 Financial support will be provided by?


I here affirm that:

All the information in this form is true and correct.
I shall abide by the laws and rules in China and the regulations of Harbin Engineering University.

申请人签字:                                                           日期:         年     月      日
Applicant's signature:                                                 Date:          Y      M       D


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