护照用名/Passport name

 姓/Family Name

名/Given Name

照片

photo

中文姓名/ Chinese Name

国籍/Nationality

护照号码Passport No.

     出生日期/ Date of Birth

     年       月      日

     Year     Month   Day

出生地点/Place of Birth

性别/Sex

婚姻状况/Marital Status

□单身/ Single  □已婚/ Married

□ 离异/ Divorced 

国籍通讯地址

Home Country Address

国家/Country                     城市/City                       电话/Tel:                              

地址/Address                                                                             

邮寄地址

Mailing Address

国家/Country                     城市/City                       电话/Tel:                        地址/Address                                                                              

手机//电子邮箱

Mobile
phone/Email
Address

手机/Mobile phone：                        电子邮箱/E-mail:

(请准确填写邮箱地址，相关通知会通过邮箱发送给你/Be sure
to provide available Email address, The notice will be sent to you via Email)

学习单位/Educational background

最高学历/Highest Academic Degree Obtained

专业/Major

时间/Year (From…to…)

工作经验Working experience (If applicable)

职业/
Occupation

特长/Skills

时间/Year (From…to…)

语言能力

Language
Proficiency

学习汉语多长时间？/How long have you learned
Chinese?                     ;（EG. Six month etc,）

Excellent □ Very Good □ Good □ Poor □；  HSK               级; 

来华学习计划

Proposed Study at SCUT

□语言进修生/Chinese
Language Student  

□本科生/Undergraduate
Candidate

□硕士研究生/Master’s Degree
Candidate □博士研究生/Doctor’s Degree Candidate

（授课语言/Language of
construction □英语/English  □中文/Chinese）

申请学院及专业School and Major You Are Applying For

申请学习时间Duration of Study

From：_______月/Month_________ 年/Year/To：_______月/Month_________ 年/Year

申请类别                      Scholarship Type to
Apply

□ 佛山科学技术学院优秀留学生奖学金/ Scholarship for Outstanding International
Students

□佛山科学技术学院留学生新生奖学金/Scholarship for
Freshmen

注：请提供最后学习经历的学习成绩单、工作证明（如适用）作为申请的辅助材料。

Note: Please
provide your most recent transcript and work certificate (if applicable) as
supportive documents.

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 in this
form is true and correct;

2.在中国学习期间遵守中国政府的法律和学校的规章制度，尊重学校的教学安排/ I
shall abide by the laws of the Chinese Government

and the regulations of the School, and will concentrate on my studies
and research, and will follow the teaching programs made by the university.

3.按规定期限修完学业，按期回国，不无故在华滞留/ I shall return to my home
country as soon as I complete my scheduled program in China,

and will not extend my stay without valid reasons.

4.如违反上述保证而受到中国法律、法规或校纪、校规的惩处，我愿意接受中止或取消奖学金及其它相应的处罚。

If I am judged by the Chinese laws and decrees and the rules and
regulations of the university as having violated any of the above, I will not
lodge any appeal against the decision on suspending, or withdrawing my
scholarship, or other penalties.

日期：     年       月     日               申请人签名：:______________________

Date:      Y       M     D                 Applicant’s Signature

(无此签名，申请无效/Only with signature should the application be
valid)

外国留学生奖学金评定委员会审核意见（签字盖章）Feedback from Scholarship Evaluation Committee at FOSU：

备注