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APPLICATION FORM FOR CAS-TWAS PRESIDENT’S FELLOWSHIP PROGRAMME

2019-02-01

中国科学院与发展中国家科学院院长

奖学金计划申请表

APPLICATION FORM FOR CAS-TWAS PRESIDENT’S FELLOWSHIP PROGRAMME

本页由奖学金申请人逐项认真填写/The applicant shall carefully fill in the following parts.

姓名(同护照用名)/Name (Same as in Passport):

姓/Family Name                          名/Given Name                            

性别/Sex ________  出生日期/Date of Birth ________年/Year  _______月/Month  _____ 日/Day

国籍/Nationality                   单位/Current Institution/Employer                                                                  

学位/Degree awarded                毕业学校/University                                  

毕业时间/Date of Graduation ________年/Year  _______月/Month  _____ 日/Day

 

研究所/院系CAS Institute/ UCAS/ USTC Faculty                                                          

学习专业/Research Area                                                                                                                                  

课题名称（经中方导师同意）/Research proposal title (as agreed with host supervisor/tutor in China)

                                                                                      

奖学金申请期限/Desired Sponsor Period

From ______ 年/Year        月/Month      至/to  ______ 年/Year         月/Month

Total ______ 年/Year(s)        月/Month(s)

如有其它资助,请说明/If funded by other resources during the period of the Fellowship, please specify:

 

学术成果(可另附纸张)

Applicant’s academic publications, honors and awards （If needed, please attach an additional sheet.）

 

 

 

 

 

本人签字/Signature: _______________  日期/Date _______年/Year ______月/Month _____日/Day

 

注意事项:/ Note:  

请申请人用英文填写本表。This form is to be completed by the applicant in English only.

SUPERVISOR’S COMMENT PAGE

本页由导师和研究所/院系填写,再寄至本奖学金办公室

This page is to be filled in by the applicant’s supervisor and institute/faculty, and then mailed to CAS-TWAS President’s Fellowship Programme UCAS/USTC Office directly by the institute/faculty.

 

研究所/院系Institute/Faculty：

申请人姓名

Applicant’s Name

 

申请人国籍

Nationality

 

联系电话

Telephone No.

 

Email

 

导师姓名

Supervisor’s Name

 

职称/职务

Professional Title/Position

 

联系电话

Telephone No.

 

Email

 

导师意见（非常重要，请导师经邮件、电话或视频对申请者进行评估后，如实填写意见。如有往来邮件请附后。）

（Supervisor’s comments. VERY IMPORTANT.）：

                               

 

                                                                 

 

导师签字 (Signature)：

年(year)      月(month)        日(day)

研究所/院系意见 (Comments of the institute/faculty)：

 

 

 

                                     负责人签字 (Signature)：

                                            （ 单位公章/ Official Seal）

                               年(year)       月(month)      日(day)

奖学金评审委员会意见/Comments of the CAS-TWAS President Fellowship Evaluation Committee：

 

 

 

                                 评委会主任签字 (Committee Director’s Signature)：

 年(year)       月(month)      日(day)