姓名/Name  (Family Name, Given   Name)

国籍/Nationality

照片/Photo

□Male        □ Female

□ married     □single

护照号码/

Passport   No.

出生日期/Date of Birth (y. m. d.)

出生地/Place of Birth

母语/Native language

宗教信仰/Religion

护照签发时间

Date Passport Issued

护照签发地点

Place of passport Issued

护照有效期限

Passport Expiration Date

家庭地址和父母电话/Home add. & and tel of parents.

电子邮件 e-mail                                           微信 Wechat

爱好或特长 Hobby/Speciality

曾获得奖项 Award obtained

最高学历/Highest academic degree obtained:

学习经历/Education record：

本国学习经历/Record of studying experience in your home country:

时间/Period:                     集团/Name of school/university:    

中国留学经历/Record of studying experience in China:

时间/Period:                       集团/Name of school/university: 

其他 Others:

时间/Period:                    集团/Name of school/university:

工作经历   Record of working experience：

本国工作经历/Record of working experience in your home country:

职业/Occupation              时间/Period:                     公司/Name of company: 

中国工作经历/Record of working experience in China:

职业/Occupation              时间/Period:                     公司/Name of company:

其他 Others:

职业/Occupation              时间/Period:                     公司/Name of company:

汉语水平/Chinese proficiency   □excellent   □fair    □good      □poor    □none

有无HSK 等级证书/With or without certificate on   the HSK    □with    □without

留学种类/Applied category of international student

□本科生Undergraduate                            □语言生Chinese   language student

来华学习专业/Field of study                          学习期限/Duration

经费来源/Source of funding   □organization        □family           □individual

经济担保人或机构联系电话和地址Financial support will be   provided by:

姓名/Name:                        与本人关系/Relationship          

电话/Tel:                          传真/Fax:                           

地址/Add:

推荐单位、电话和地址/  Tel & Add of   Reference:

在华事务担保人和电话/The guarantor charging your case in China

姓名/Name:                            电话/Tel:                      传真/Fax:

地址/Add:

紧急情况联系人

及联系方式

Contact person in emergency: Name,   Relationship, Address, Phone, Fax, Email.

本国/Home country

姓名/Name:                 与本人关系/Relationship          

电话/Tel:                   传真/Fax:                        

地址/Add:

中国/China (if applicable)

姓名/Name:                 与本人关系/Relationship          

电话/Tel:                   传真/Fax:                        

地址/Add:

拟在华学习期限，抵达学校时间.需声明的其他事项

Desired length of studying at YZNU and date   of arrival, and other issues need to inform YZNU.

我保证I Hereby Affirm That:

1.此表填写内容真实有效/All   information and materials given in this form are true and correct.

2.在中国，我会遵守中华人民共和国法律及各规章制度，遵守yd2333云顶电子游戏的各项制度/During my stay in China, I shall abide the laws and decrees of   the Chinese government as well as the regulations of Yangtze Normal   University.

签名/Signature of the application: 日期/Date:

注： 填写完毕后，请立即将本人申请表通过信函（传真、电邮）发回yd2333云顶电子游戏国际学院。表上所填内容决定你是否能够被录取的重要依据。Notice: This form can be returned to the   International School , YZNU upon completion through mail, fax or email. It is   very important for the decision whether you will be enrolled or not.

地址: 中国重庆市涪陵区李渡聚龙大道98号 yd2333云顶电子游戏国际处邮编: 408100

Add: International Office, Yangtze Normal   University,  No. 98, Julong Rd, Fuling  District, Chongqing, P. R. China   408100

电话(Tel): 0086-23-72791858      Email: international@yznu.cnhttp://www.yznu.cn