外国人体格检查记录PHYSICALEXAMINATIONRECORDFOR.docVIP

江 南 大 学 校 际 交 换 学 生 学 习 申 请 表 Jiangnan University Application Form for Incoming Exchange Student 所在学校/Home University: 申请日期/Date (mm/dd/yyyy): 申请人/Name of Applicant: (Please write your family name in capitals) 请在申请时提供下列完整的材料 Please send this application in a completed package containing all the following documents. 申请材料清单/Check List (1) (2) (3) (4) (5) (6) (7) 申请表/A completed Application Form 学习计划/A completed Study Plan Form 成绩单/A Transcript of Academic Records 在读证明/A Certificate of Enrollment 护照复印件/A copy of Passport 推荐信/A Recommendation Letter by Home University 外国人体格检查记录 PHYSICAL EXAMINATION RECORD FOR FOREIGNER □ □ □ □ □ □ □ This application package should be sent to the following address through the office responsible for student exchange at applicants home university. International Office Jiangnnan University No 1800,Lihu Avenue,Wuxi,Jiangsu 214122 Tel: 0510 Fax:0510 Email: jqin@jiangnan.edu.cn 照片 Photo 1.本人简历/Personal information 姓 名 Family name:__________________________ Given name:___________________________ 出生日期（日/月/年） 出生地 Date of Birth(day/month/year)____/____/_______ Place of birth_____________________ 性别/Sex: _______ 婚姻状况/Marital Status: ___________ 宗教信仰/Religion:_________ 国籍/Nationality: _____________________ 护照号码/Passport No. __________________ 永久通讯地址及电话/Permanent address and Tel. No. ________________________________ _____________________________________________________________________________ 2.受教育情况/Educational background: 所在学校/Home University：______________________________________________________ 攻读学位/Degree sought(e.g.Diploma,Bachelor,Master,Doctorate):________________________ 已学习时间/Number of higher education study years prior to departure:____________________ 所修专业/Major/minor field(s) of study:_____________________________________________ 语言熟练程度/Language proficiency: 很好/excellent