吉林省政府外国留学生奖学金（长白山奖学金）-DAFF.doc

吉林省政府外国留学生奖学金（长白山奖学金）申请表 APPLICATION FORM FOR JILIN PROVINCIAL GOVERNMENT SCHOLARSHIP 请申请人认真阅读本表第四页的填表说明。请用中文或英文填写此表格。请用电脑打印或用蓝色或黑色钢笔认真书写表格内容。请在所选项框内划“X”表示，不按规定填写的表格将视作无效。 Please read carefully the important notes on the last page before filling out the form. Please complete the form in Chinese or English. If the form is not filled in on PC, please write legibly in black or blue ink. Please indicate with ‘X’ in the blank chosen. Any forms that do not follow the notes will be invalid. 1. 申请人情况/Personal Information: 护照用名/Passport Name: 姓/Family Name: 名/Given Name: 国籍/Nationality: 护照号码/Passport No.: 出生日期/Date of Birth: 年/Year 月/Month 日/Day 出生地点/Place of Birth: 国家/Country: 城市/City: 男/Male:□ 女/Female:□ 已婚/Married:□ 未婚/Single:□ 其它/Other:□ 母语/Native Language: 宗教/Religion: 当前联系地址/Present Address: 电话/Tel: 传真/Fax: E-mail: 永久通信地址/Permanent Address: 2. 受教育情况/Education Background: 学校 在校时间 主修专业 毕业证书及学位证书 Institutions Years Attended(from/to) Fields of Study Certificates Obtained or To Obtain 3. 工作经历/Employment Record: 工作单位 起止时间 从事工作 职务及职称 Employer Time(from/to) Work Engaged Posts Held