“一带一路”国家高等教育机构卓越女性领导力培训项目申请表
Application Form of theWomen’s Leadership Training Program for Excellent Women from Higher Education Organizations of “The Belt and Road” Countries
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护照用名/Name in passport
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姓/Family name
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中文名/Chinese name
(if applicable)
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照 片
Photo
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名/Given name
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国籍
Nationality
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出生地点
Place of birth
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出生日期
Date of birth
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年 月 日
/year /month /date
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男 □Male
女 □Female
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已婚□Married
未婚□Single
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护照号码
Passport No.
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宗教/Religion
(if applicable)
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最后学历/Highest education
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现职务/
Title & Job Positions
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现工作单位/Current employer
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永久通讯地址/Permanent mailing address:
电话/Tel: 传真/Fax:
E-mail 1:
E-mail 2（backup）:
Note: It is highly suggested that provide two email addresses and avoid to use Gmail for technical reasons.
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目前通讯地址/Current address if different:
电话/Tel: 传真/Fax: Email:
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申请专业
Application major
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研究方向
Research topic
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现有英语水平/English language proficiency:
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本人简历/Curriculum vitae
单位 时间（年/月——年/月） 主修专业
Previous and Current Education & Employer Years Attended(from/to) Fields of Study
______________________ ____________ ____________________ _________________
______________________ ____________ ____________________ _________________
______________________ ____________ ____________________ _________________
______________________ ____________ ____________________ _________________
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紧急联系人（紧急联系人可以是父母或者亲戚朋友，国籍不限，但学生不能做紧急联系人）/Emergency contact during your stay at BLCU(Contact person can be a parent or relative of applicants. The applicant cannot be the contact person )
姓名/ Name: 国籍/ Nationality: 与本人关系/Relationship to the applicant:
永久通讯地址/Permanent mailing address:
单位/ Name of employer:
住宅电话/Home Tel: 办公室电话/Office Tel:
传真/ Fax: Email:
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我愿意到中华女子学院学习，在学习期间保证做到下列各项/I am willing to participate in the training program held at China Women’s University. I pledge the following terms during my training:
1. 遵守中华人民共和国法律；
I will abide by the laws of the People’s Republic of China.
2. 不从事学习目的以外的活动；
I will not engage in activities bearing no relation with my training in China.
3. 遵守学校的各项规章制度；
I will observe all rules and regulations of the University.
申请人本人签字/Signature of the applicant:
日期/Date:
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