上海政府奖学金B类申请表模板.doc

上海市外国留学生政府奖学金申请表（B类）

APPLICATION FORM
FOR SHANGHAI GOVERNMENT SCHOLARSHIP (SGS)
CLASS B
申请就读学校
Institution to Apply for

申请人姓名
Name of Applicant

填表日期
Date
年 月 日
Year Month Date
申请编号
No. of Application

上海市教育委员会 编制
Designed by Shanghai Municipal Education Commission
目 录

一、 本申请表填写说明……………………………………………………………………3
Guidelines for Filling in This Application Form

二、 上海市外国留学生政府奖学金申请表………………………………………………5
Application Form

三、 申请人确保书…………………………………………………………………………8
Letter of Guarantee

四、 所附材料情况……………………………………………………………………….....9
Materials Attached
申请表填写说明书
（序号与申请表中每一项序号相对应）
GUIDELINES FOR FILLING IN THE APPLICATION FORM
(THE ORDINAL NUMBERS CORRESPOND TO THE ORDINAL NUMBERS IN THE FORM)

本表为上海市外国留学生政府奖学金（B类）申请表, 在填写本申请表之前请具体阅读《上海市外国留学生政府奖学金申请管理措施》及《上海市外国留学生政府奖学金（B类）申请细则》, 了解申请上海市外国留学生政府奖学金（B类）资格条件及相关要求。
This is the Application Form for Shanghai Government Scholarship (SGS) for International Students (Class B). Before you fill in this form, please read carefully The Administration Methods for the Application for Shanghai Government Scholarship for International Students and The Details for Application for Shanghai Government Scholarship for International Students so as to learn about the qualifications and related regulations of applying for Shanghai Government Scholarship for International Students (ClassB)

请申请人认真阅读以下填表说明。请用汉字或英文填写此表格。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‘X’。不按要求填写申请表将视作无效。
Please read carefully the important notes below before filling in the form and complete the form either in Chinese or English. If the form is not filled in on the computer, please write legibly in black or blue ink. Please indicate with‘X’in the blank chosen. Any application form that does not follow the notes will be regarded as invalid.

1. 申请人全部个人信息必需如实填写。
All personal information about the applicant must be filled in truly and correctly.

2. 请列出你已经完成或立即完成各级教育, 包含中学、 职业教育及高等教育各项。请随材料附上经公证你最高学历证实、 毕业证书或学位证书和学习成绩单原件复印件和英文翻译件。
Please provide the following information about all the secondary, vocational, technical, undergraduate or post graduate training and qualifications you have completed. Notarized copies and English translations of your highest education certificate, graduation and degree certificates and official transcripts of study records must be submitted together with the application form.

3. 请列出你曾经从事和现在从事工作与现任职务。
Please clarify your work experiences and your present post.

4. 本项说明你语言水平情况, 尤其是汉语和英语水平。这对你对申请人来华后课程安排及讲课语言非常关键。请随申请表附上相关证实材料。
Please state your proficiency levels of languages, especially Chinese and English, as this is very important for the arrangement of the courses and the language used for teaching after you arrive in China. If you have passed a language test, please include a copy of the results in your application materials. Please attach related proof materials.

5. 请按本项提醒选择与填写来华后学习计划
Please choose or fill in your study plan in China according to the clues given in this item.

6. 请说明你从事研究题目或基础内容, 亦能够列出你期望在华学习部分课程。这对于学校确定你学习专业及讲课老师非常关键
Please illustrate the subject of your research or the main content of your study. You may also give some courses you want to attend in China. This is crucial for the university to decide your major and arrange the course teachers for you.

7. 请列出申请人曾经发表或曾写过论文、 著作、 作品。
Please list your academic papers, works and artworks published, if any.

8. 在华联络人或联络机构, 相关申请人在华相关事务, 我们将与其联络。
Please provide the person in China in charge of your application affairs if you have so that we will contact him/her for your application affairs when necessary.

9. 假如你曾在中国学习或工作过, 请通知你在华学习院校或工作单位。
If you have ever studied or worked in China, please specify your institution or employer and time in China。
10. 请填写你亲属基础情况。
Please fill in the general information about your family members.
上海市外国留学生政府奖学金申请表（B 类）
APPLICATION FORM
FOR SHANGHAI GOVERNMENT SCHLARSHIP (SGS) CLASS B

照片
Photo
1. 申请人情况/Personal Information:
护照用名/ Name as in Passport:
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:_____________
性别/Sex: 男/Male □ 女/Female □
婚姻情况/Marital Status: 已婚/Married □ 未婚/Single □ 丧偶/widowed □ 离异Divorced □
母语/Native Language:_ ____ 宗教/Religion:________ ______________
目前联络地址/Present Address:__________________ _____ ________________
电话/Tel: ____ ___ 传真/Fax: ____________ E-mail: ________________________
永久通信地址/Permanent Address: __________________ __________________

2. 受教育情况/Education Background:

学校
Institutions
在校时间
Years Attended
(from/to)
主修专业
Fields of Study
毕业证书及学位证书
Certificates Obtained

3. 工作经历/Employment Record:
工作单位
Employer
起止时间
Time (from/to)
从事工作
Work Engaged
职务及职称
Post/Academic Status

4. 语言水平/Language Proficiency:
a) 汉语/Chinese:
很好/Excellent: □ 好/Good □ 通常/Fair □ 差/Poor □ 不会/Don’t Know □
HSK 考试等级或其她汉语水平证书/ Level of HSK or other certificates which can show your Chinese level:__ ______________________________________
b) 英语/English:
很好/Excellent: □ 好/Good: □ /Fair: □ 差/Poor: □ 不会/None: □
我能够用英语学习专业课程/I can learn the special courses in English:
是/Yes □否/No □
c) 其她语言/Other Languages:________________水平/Proficiency

5. 来华学习计划/Proposed Study in China:

a) 本科（学士）/Undergraduate (Bachelor’s Degree) Program □
硕士学位/Master’s Degree Program □
博士学位/Doctor’s Degree Program □

b) 学习专业 / Major of Study:
c) 学习时间 / Duration of the Study:
自/From: ______年/Year___月/Month 至/To: ______年/Year__月/Month

6. 拟在华学习或研究具体内容（可另附纸）
Please describe the details of your study or research plan in China (an extra paper can be attached if this space is not enough):
____________ ____________________________________________
____________ ____________________________________________
____________ ____________________________________________
____________ ____________________________________________

7. 曾发表关键学术论文、 著作及作品/Academic Papers, Works & Artworks Published:
____________ ____________________________________________
____________ ____________________________________________
____________ ____________________________________________

8. 在华负责你申请事务联络人/The Person in China in Charge of Your Application Affairs:
姓名/Name:___ ______电话/Tel:___ _____ 传真/Fax:_________________
地址/Address:_____________________ _______________________
9. 申请人是否曾在华学习或任职/Have you ever studied or worked in China?
是/Yes: □ 学习或任职单位/Institution or Employer: _________ _____________
在华时间/Time in China: 自/From:_____年/Year 月/Month至/To:_____年/Year____月/Month
否/No: □
10. 申请人亲属情况/Family Members of the Applicants:
姓 名 年 龄 职 业
Name Age Occupation
配偶/Spouse: ______________
父亲/Father : ______________
母亲/Mother: ______________
申请人确保书
Letter of Guarantee

1. 我确保申请表中所填写全部内容和提供材料真实无误;
I hereby affirm that all the information and materials given in this form are true and correct.
2. 我确保除上海市外国留学生政府奖学金外未申请同一时间其她中国政府奖学金;
I ensure that besides the SGS, I have not applied for any other Chinese government scholarships within the period I study in Shanghai.
Shanghai
3. 在华期间, 我将遵守中国法律、 法规, 不从事任何危害中国社会秩序、 与本人来华学习身份不符合活动;
During my stay in China, I shall abide by the laws and decrees of the Chinese government, and will not participate in any activities which are deemed to be adverse to the social order of China and are inappropriate to my capacity as a student.
4. 我在享受奖学金期间不无故要求变更学校和所学专业;
During the period of my getting SGS, I shall not apply for any changes of institution and specialty of study without valid reasons.
5. 在学期间, 我将遵守学校校纪、 校规, 全力投入学习和研究工作。尊重学校教学安排;
During my study in China, I shall abide by the rules and regulations of the host university, concentrate on my studies and researches, and follow the teaching programs arranged by the university.
6. 我将根据要求参与上海市外国留学生政府奖学金年度评审;
I shall go through the procedures of the annual assessment of SGS status as required.
7. 我将按要求期限修完学业, 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 study program in China, and will not extend my stay in China without valid reasons.
8. 如违反上述确保而受到中国法律、 法规或校纪、 校规惩处, 我愿意接收上海市外国留学生政府奖学金管理委员会中止或取消奖学金及其它对应处罚。
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 of SGS administration on suspending, or withdrawing my scholarship, or other corresponding penalties.

申请人签字/Signature of the Applicant:

日期/Date:__ ______________________________
（无此署名, 申请无效/The application is invalid without the applicant’s signature）
所附材料情况
（请在所附附件前划‘X’标明）
Materials Attached (Please Indicate with ‘X’in the Bracket.)

□ 本人护照复印件/A Copy of the Passport.
□ 两封推荐信/Two Letters of Recommendation.
□ 本人最终学历成绩单复印件（须公证）/Transcripts of Study Records of the Most Advanced Studies (Notarized Photocopy).
□ 本人最终学历证书复印件（须公证）/Diploma of the Most Advanced Studies (Notarized Photocopy):
本科/Bachelor’s Degree □ 硕士/Master’s Degree □ 博士/Doctor’s Degree □其它/Others □
□ 来华学习计划/ Study Plan in China.
□ 所发表文章等/ Articles or Papers Published.
□ 美术作品（本人作品彩照六张）、 音乐作品（本人音乐作品盒式录音带一盘）（只限申请美术和音乐专业申请人）/Examples of Artworks (6 color pictures) or Music Works (1 audio tape) (Only for the applicants applying for Fine Arts and Music).
□ 其它附件（请列出）/Other Attachments (A List Is Needed)

__________________________________________________________
注: (1) 每份申请材料最多不超出20页, 请全部使用A4纸。
Each set of the complete materials should not exceed 20 pages. Please use A4 size paper.
(2) 不管奖学金申请是否被同意, 上述申请材料恕不退还。
Whether the application for SGS is apprived or not, all the application materials will not be returned.
材料粘贴处/Attach Your Materials Here: