PAGE４该栏由学校填写Thisistobefilledinbytheuniversity.编号___________________类别___________________专业___________________推荐___________________经费___________________外国留学生（非学历进修生）入学申请表ApplicationFormforInternationalStudents（GeneralAdvancedStudent/SeniorAdvancedStudent）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）FullNameinEnglishaccordingtoyourpassport姓FamilyName:照片PHOTO中间名MiddleName:名GivenName:中文名ChineseName必须填写，不超过6个汉字。Thismustbefilledinnomorethansixcharacters.国籍CountryofCitizenship性别Gender□男Male□女Female出生日期DateofBirth年/Year月/Mon日/Date出生地点PlaceofBirth国家Country______________________城市City______________________护照号码PassportNo.护照有效期Passportvaliduntil年/Year月/Mon日/Date婚姻状况MaritalStatus宗教信仰Religion职业Occupation工作/学习单位Employer/Institution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通知书邮寄地址MailingAddressfortheAdmissionPackage该地址若有变化，请及时通知留学生办公室。(PleaseinformtheInternationalStudentsOfficeofanychangeofthisaddressincasetheadmissionpackagecan’treachyou.)收件人Receiver邮政编码ZipCode电话/传真Tel/Fax推荐单位Recommendedby联系人Contactperson联系地址Address电话/传真Tel/Fax学习经历（从中学起填写）Educationalbackground（FromMiddleSchool）学校名称Institutions在校时间Yearsattended(from/to)主修专业Fieldofstudy所获文凭Diplomareceived————————————————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学习计划（请选择）StudyPlan(Pleasechoose)申请类别Category学习专业SubjectofStudy指导教师Advisor□高级进修生SeniorAdvancedStudent专业Major：与相关复旦教师的联系情况：ContactwithrelatedFudanteachers:□普通进修生GeneralAdvancedStudent专业Major：申请学习时间DurationofStudy自/From年/Year月/Mon日/Date至/To年/Year月/Mon日/Date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：E-mail：保证人签名Gu