温州大学国际学生III类奖学金申请表

温州大学国际学生III类奖学金申请表

Application Form of Class III Scholarship for International Students of Wenzhou University

请申请人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‘√’’表示。不按规定填写的表格将视作无效。

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：□

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:

_______________________________________________________________________________

中国工商银行用户名ICBC CARD ACCOUNT NAME:

_______________________________________________________________________________

中国工商银行账户ICBC CARD NUMBER:

_______________________________________________________________________________

2. 学生类别/Type of Student:

□语言生Language Student

□本科生Undergraduate Student

□硕士生 Postgraduate Student

3. 申请奖学金类别/Scholarship Applied:

A.一等奖学金/First Prize Scholarship:□ B.二等奖学金/Second Prize Scholarship: □

C.三等奖学金/Third Prize Scholarship: □

推荐您申请我校奖学金的机构或个人/Please Specify the Organization or Person Recommending you for this Scholarship:

_______________________________________________________________________________

4.上一学年是否获得其他非温州大学颁发的奖学金/Have you been awarded any Scholarships offered by other organizations instead of WZU in the recent Academic Year:

是/Yes: □ 请说明/Please Specify ____________________________________________

否/No: □

5.在温大期间所学专业/Education Background at WZU:

在校时间/ Years Attended (from—to)

_______________________________________________________________________________

主修专业及所在学院/ Fields of Study & College

_______________________________________________________________________________

学分绩点/Grade Point Average:

_______________________________________________________________________________

6.在温大期间的活动经历/Activities Record at WZU:

专业技能/Professional Skills:

_______________________________________________________________________________

_______________________________________________________________________________获奖情况/Rewards:

_______________________________________________________________________________

_______________________________________________________________________________

其他活动/ Other Activities

_______________________________________________________________________________

_______________________________________________________________________________

7.曾发表的主要学术论文、著作及作品/Academic Papers, Writing & Art Works Published:

_______________________________________________________________________________

_______________________________________________________________________________

8.语言能力/Language Proficiency:

a) 汉语/Chinese:

很好/Excellent □ 好/Good □ 较好/Fair □ 差/Poor □ 不会/None □

HSK 考试等级/ Level of HSK test ________________________________________________

b) 英语/English:

很好/Excellent□ 好/Good □ 较好/Fair □ 差/Poor □ 不会/None □

我的英语水平可以用英语学习/I can be taught in English: 是/Yes □ 否/No □

c) 其他语言/Other Languages:

____________________________________ ____________________________________

9.所附材料情况（请在所附附件前划‘√’标明）/Materials Attached (Please Indicate with ‘X’ in the blank chosen.):

□ 本人最后学历证书（复印件）/Diploma of the Most Advanced Studies(Photocopy)：

本科/Bachelor’s □ 硕士/Master’s □ 博士/Doctor’s □ 其它/Others □

□ 本人护照（复印件）/Passport

□ 其他辅助申请的补充材料（复印件）/ Other Supplemental Materials for the Application(Photocopy).

申请人保证/I Hereby Affirm That

1.申请表中所填写的内容和提供的材料真实无误；

All information and materials given in this form are true and correct.

2.在华期间，遵守中国的法律、法规，不从事任何危害中国社会秩序的、与本人来华学习身份不符合的活动；

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

3.在学期间，遵守学校的校纪、校规，全力投入学习和研究工作。尊重学校的教学安排，不无故旷缺课；

During my study in China, I shall abide the rules and regulations of the host university, and concentrate on my studies and researches, and follow the teaching programs arranged by the university.And will not miss or be absent from any lessons without valid reasons.

4.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.

5.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, or withdrawing my scholarship, or other penalties.

申请人签字/Signature of the Applicant:___________________

日期/Date: ___________________

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