PAGE４该栏由学校填写Thisistobefilledoutbytheuniversity编号____________类别____________专业____________语言____________推荐____________费用____________日期____________外国留学生（研究生）入学申请表ApplicationFormforInternationalStudents（MasterandPh.DProgram）请申请人用中文或英文清楚地填写以下诸项，并打印。不接受手写。不能缺项填写，没有的请写“无”。Pleaseprintalltheinformationrequested.Handwritingisnotacceptable.PleasewriteNoneifnotapplicable.护照名（英语）FullNamewithMiddleInitialinEnglishaccordingyourpassport姓FamilyName:照片PHOTO中间名MiddleName:名GivenName:中文名ChineseName国籍Countryofcitizenship性别Gender□男Male□女Female出生日期Dateofbirth年/yy月/mm日/dd出生地点Placeofbirth国家Country_________________________城市City_________________________护照号码PassportNo.护照有效期Validuntil年/yy月/mm日/dd宗教信仰Religion婚姻状况MaritalStatus职业Occupation学习或工作单位Institution/Employer电话、手机Tel&Cellphone电子邮件E-mail本国住址HomeCountryAddress邮政编码ZipCode电话/传真Tel/Fax录取通知书邮寄地址MailingaddressfortheAdmissionpackage如地址有变，请及时告知。PleaseinformtheInternationalStudentsOfficeforanychangeofthisaddress.收件人Receiver邮政编码ZipCode电话/传真Tel/Fax学习经历（从中学开始填写）Educationalbackground（FromMiddleSchool）学校名称Institutions在校时间Yearsattended(from/to)主修专业Fieldofstudy所获证书Diplomareceived证书编号No.ofDiploma——————————工作经历EmploymentRecord工作单位Employer起止时间Yearsattended(from/to)从事工作Occupation职务Position——————语言能力，请用“好，一般，不会”评价。Languageproficiency（Good/Average/None）汉语ChineseHSK：_______级;新HSK(□初级、□中级、□高级)：__________;BCT：____________英语EnglishTOEFL(score)________；GMAT_________；GRE_________；IELTS____________其他Other推荐单位Recommendedby推荐单位Recommendedby联系人Contactperson联系地址Address电话/传真Tel/Fax在复旦大学的学习计划StudyPlanatFudan(pleaseclickwhatyouplantostudy)申请类别Category专业或专题Majororfieldofstudy指导教师/Advisor(OnlyforDoctoralProgram)□博士研究生Doctoralcandidate□硕士研究生Mastercandidate申请专业/Major：研究方向Researchfield：申请学习时间Durationofstudy自/From年/yy月/mm至/To年/yy月/mm经费来源FinancialSupport□自费Self-support保证人姓名Guarantor'sname：与申请人关系Relationshipwiththeapplicant：地址Address：电话/传真Tel/fax：保证人签名Guarantor'ssignature：□奖学金Scholarship奖学金名称Scholarshipnam