访问学者申请表(含研修计划表).pdf

The GRADUATE SCHOOL of ARTS AND SCIENCES HARVARD UNIVERSITY Visiting Fellow Application Academic year for which you are applying: _____________________ Full academic year Fall term only Spring term only Please submit this application with the $70 application fee. Acceptable forms of payment include: any domestic (US) check or money order made payable to Harvard University; foreign checks or money orders if drawn against a corresponding US bank; any Canadian check or money order if drawn in US dollars; Japanese postal money orders. The application fee is not refundable. TYPE OR PRINT LEGIBLY. 1. Full legal name: ______________________________________________________________________________________________________ (Use no initials. Circle your family name.) 2. If your records have ever been filed under another family name, give that name: ______________________________________________ 3. Current mailing address: 7. Gender: _____ Male _____ Female _____________________________________________________ 8. Birthdate: _____________________________________________ _____________________________________________________ month day year _____________________________________________________ 9. Social Security # (US citizens): ___________________________ _____________________________________________________ 10. City and country of birth: _______________________________ Good until: ___________________________________________ 4. E-mail address: ________________________________________ 11. Citizenship: ___________________________________________