Education and Training
ADMISSION APPLICATION FORM FOR INTERNATIONAL STUDENTS
国 际 学 生 入 学 申 请 表
ADMISSION APPLICATION FORM FOR INTERNATIONAL STUDENTS
第一部分/Part I
请申请人认真阅读本表最后一页的注意事项，准确无误填写下列各项。
Please carefully read the instructions given at the end and fill in the form without any mistakes.
一、个人信息/Personal Information
| 1（1）护照姓/Surname in Passport
| 1（2）护照名/Given Name in Passport
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| 2. 中文姓名/Chinese Name (If any)
| 3. 性别/Sex
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| 4（1）出生日期/Date of Birth
| 4（2）出生地点/Place of Birth (City/Province) | |
| 4（3）出生地点/Place of Birth (Country) | 5. 国籍/Nationality
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| 6（1）护照类别/Passport Type
| 6（2）护照号码/Passport No
| 6（3）有效期/Expiry Date
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| 7. 婚姻状况/Marital Status
| 8. 宗教信仰/Religious Belief (If any)
| 9. 身高/Height cm |
二、联系信息/Contact Information
| 10（1）永久通讯地址/Permanent Address
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| 10（2）电话/Tel.
| 10（3）传真/Fax
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| 11（1）目前通讯地址/Current Correspondence Address (if different from permanent address, please specify)
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| 11（2）电话/Tel.
| 11（3）传真/Fax
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| 12（1）电子邮件/Email Address
| 12（2）备用电子邮件/Backup Email Address
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三、报考志愿/Application Preference
| 13. 学生类别/Student Category
| 14. 院系|研究所/ UCAS School/College/CAS Institute
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| 15. 学习专业/Research Subject or Field
| 16. 授课语言/Expected Teaching Language
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| 17（1）导师/Host Supervisor
| 17（2）接受调剂Agree to Change a more suitable supervisor
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| 18. 学习时间/Studying Period: 自/From 至/To | |
| 19. 研究计划/Research Proposal
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四、受教育情况与工作经历/Education Background and Working Experience
20. 最高学历/Highest Diploma
| 20（1）最高学位/Highest Degree Obtained/to be Obtained
| 20（2）得时间/Obtaining Date
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| 20（3）毕业院校/Institution
| 20（4）所在国家/Country
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21. 教育背景(从大学时代起,按先后顺序填写)/Educational Background (From Undergraduate study, in Chronological Order)
| 学校 Institution | 地点 Location | 在校时间 Years Attended | 主修专业 Study Field | 所获证书、学位 Diploma/Certificate |
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21. 当前工作/Current Job
| 21（1）当前工作单位或在读院校/Current Employer or School/University
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| 21（2）当前职位/Current Position
| 21（3）工作/学习地点/Location (City, Country)
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22. 工作经历（从大学毕业后写起，按时间顺序填写）Work Experience (After Undergraduate Study, in Chronological Sequence)
| 工作单位 Employer | 地点 Location | 起止时间 Years Attended | 从事工作 Work Engaged | 职务及职称 Position |
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22. 语言能力/Language proficiency
| 22（1）母语/Mother Tongue
| 22（1）是否为官方语言/Official Language or Not
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| 22（1）汉语水平/Chinese Proficiency HSK(New) Level
| 22（2）考试时间/Date of Test
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| 22（3）考试成绩/Test Score
| 22（4）可否使用中文学习/Can you study in Chinese or Not
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| 23（1）英语是否为官方语言/Is English an Official Language or Not
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| 23（2）英语水平考试种类Name of English Test
| 23（3）考试时间/Date of Test
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| 23（4）考试成绩/Test Score
| 23（5）可否使用英文学习/Can you Study in English or Not
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| 24（1）其他语言（一）/Other Language (1)
| 24（2）其他语言（一）/Other Language (1) Proficiency
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| 25（1）其他语言（二）/Other Language (2)
| 25（2）其他语言（二）/Other Language (2) Proficiency
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26. 特长爱好/Specialty/Hobby
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27.已发表的代表性论著/Representative Published Papers/Works
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| 序号 ID | 论著类型 Type of Publication | 卷（期） Volume (Issue) | 页码 Page | 期刊名称/会议名称/著作名称 Name of Journal/Conference/Academic Work |
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五、亲属、推荐人及在华联系人信息
28. 家庭成员/Family Member
| 姓名 Full Name | 关系 Relationship | 职业 Occupation | 电话 Telephone |
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29. 紧急情况联系人（不能是学生）/Contact Person in Case of Emergency (Student cannot be the contact person):
| 姓名 Full Name | 与申请人关系 Relationship | 职业 Occupation | 电话 Telephone |
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| 目前通讯地址/Current Correspondence Address | 传真/Fax | 电子邮件/Email | |
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30. 推荐人/Referees
| 姓名 Full Name | 工作单位 Employer | 职务及职称 Professional Title | 联系电话 Telephone | 电子邮箱 |
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31. 经费来源（请选择）/Financial Support for Study at UCAS
本人已获资助（请附资助证明）/I have financial support（Please attach the certificate of financial support）。
资助机构是/The organization(s) is/are:
本人目前尚未获得任何奖学金资助，但已向该机构提出奖学金申请/I currently don't have any scholarship, but has submit scholarship application to the organization(s):
本人未获任何奖学金资助，拟向国科大申请以下奖学金，希望获得其中一个项目的资助（注：可同时申请多个奖学金项目。一旦入选其中任何一个项目，则将自动依次丧失其他项目的参评资格）/I have not got any financial support. The Fellowship/Scholarship(s) I wish to apply for is/are (Please attach separate application form(s) for each fellowship/scholarship. You can apply for multiple scholarships. However, once you were selected as an awardee of one of the following scholarship programs, you will not be qualified for other scholarships):
中国政府奖学金/Chinese Government Scholarship (Applicants shall visit the scholarship online application system at http://www.csc.edu.cn/laihua/ and complete the online application procedure).
中国科学院—发展中国家科学院院长奖学金计划/CAS-TWAS President’s Fellowship (Applicants shall visit the fellowship online application system at http://www.fellowship.cas.cn and complete the online application procedure).
中国科学院“一带一路”硕士生奖学金计划/CAS “The Belt and Road” Master Fellowship Programme (Applicants shall visit the scholarship online application system at http://adis.ucas.ac.cn and complete the online application procedure).
中国科学院大学国际学生全额奖学金/UCAS Full Scholarship for International Students (Applicants shall visit the scholarship online application system at http://adis.ucas.ac.cn and complete the online application procedure).
中国科学院大学国际学生部分奖学金/UCAS Partial Scholarship for International Students (Applicants shall visit the scholarship online application system at http://adis.ucas.ac.cn and complete the online application procedure).
自费：在华学习期间的费用本人自己承担（请附担保人出具的经济担保函及银行证明原件或公证件）/Self-Supporting: My study at UCAS will be financially supported by myself (Please attach the affidavit of support from the guarantors and a bank statement (Original document or Notarized copy)).
32. 其他需要说明的问题/Other information you would like to provide
33. 声明/Declarations:
申请人保证:/I hereby affirm:
1. 上述情况真实无误。/ I have reviewed the above information, and it is true and complete to the best of my knowledge.
2. 在中国学习期间遵守中国的法律和中国科学院大学的规章制度。/I shall abide by the laws and regulations of China as well as the rules and regulations of UCAS during my study period in China.
申请人签字/Signature: 日期/Date:
（无此签名，申请无效/ The application will be invalid without applicant’s signature）
第二部分/Part II
| 本页由导师和研究所/院系填写This page is to be filled in by the applicant’s supervisor and host institution | |||||
| 学生姓名 |
| 国 籍 |
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| 学生类别 |
| 学习专业 |
| 专业代码 |
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| 导师姓名 |
| 工作单位 |
| 职称/职务 |
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| 联系电话 |
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| 导师意见： 1. 评语（请从英语/汉语水平，专业知识及运用能力，科研态度、兴趣及与导师研究课题相关性等方面评价）
2. 担任申请人导师（请选择√）： □ 同意 □ 不同意
导师签名： 日期： 年 月 日
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| 研究所/院系招生意见： 1. 入学申请材料初审（请选择√）：□ 通过 □ 未通过 2. 拟录取意见（请选择√）： □ 同意 □ 不同意 3. 学习方式（请选择√）： □ 全日制 □ 兼读制 4. 授课语言：□ 英语 □ 汉语 5. 若该生未得任何奖学金项目的资助，是否建议录取（请选择√）： □ 是，我单位将为该生在华学习期间提供生活费和基本住宿等； □ 否。 6. 其他（如有，请说明）：
我单位承诺该生在华期间遵守中国法律，我单位负责其在华期间的学习和生活相关事宜。
研究所/院系公章
负责人签字： 日期： 年 月 日
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| 国科大意见：
□ 同意录取 □ 不同意录取
中国科学院大学公章
负责人签字： 日期： 年 月 日 | |||||
注意事项/ Instructions:
1. 中国科学院大学机构代码为80001。/The Agency Number of UCAS is 80001.
2. 请申请人用中文或英文准确无误地填写，其他文字及缺项未填的申请表无效。需在本表相应框内做出选择的地方，请用符号“P”表示。/This form is to be filled out by the applicant in Chinese or English. Any incomplete application form or complete application form in languages other than Chinese or English will not be accepted. Please use “P” to tick the box in the relevant items to indicate your selection.
3．有需要向国科大申请奖学金资助的，请填写相应的奖学金项目申请表，并随入学申请表一起提交；如没有一并提交，则视为没有申请该奖学金项目。申请人可同时申请多个奖学金项目。一旦获得任何一个奖学金项目资助，将自动依次丧失其他奖学金项目的参评资格。/Applicants who need to apply for finial support via UCAS must fill in and submit the relevant Fellowship/Scholarship application form(s) with the admission application form. Applicants may simultaneously apply for more than one Fellowship/Scholarship(s). Once awarded or funded by any one program, they would be disqualified for rest of the programs during the term.
4．中国科学院—发展中国家科学院院长奖学金计划、中国政府奖学金、中国科学院大学国际学生全额奖学金和部分奖学金的具体内容详见国科大英文网站http://english.ucas.ac.cn/。//For information about CAS-TWAS President’s Fellowship, Chinese Government Scholarship, UCAS Full and Partial Scholarship, please visit UCAS website http://english.ucas.ac.cn/.
5. 报名费（不予退还）： 博士和硕士人民币600元；普通、高级进修生人民币450元。申请中国科学院—发展中国家科学院院长奖学金计划、中国政府奖学金的，不需缴纳报名费。/Admission fee (Non-refundable): For PhD and Master’s Students RMB 600; for visiting students and senior visiting students RMB 450. Applicants for CAS-TWAS President’s Fellowship andChinese Government Scholarship shall be exempted from the admission fee.
申请者须将报名费汇至以下银行账户（请注明此款为报名费）/ Applicants have to submit Admission fee in Chinese currency (RMB ) in favor of the University of Chinese Academy of Sciences:
开户名称：中国科学院大学
开户银行：中国建设银行北京东方广场支行
银行账号：11001059200053002790
Beneficiary: University of Chinese Academy of Sciences
Account number: 11001059200053002790
Bank: Construction Bank of China
Beijing Municipal Dongfang Guangchang Branch
SWIFT CODE：PCBCCNBJBJX
6．申请人须将本申请表连同以下材料寄至研究所或院系。一经提交，所有申请材料恕不退还。请勿邮寄未经导师签字、研究所/学院盖章的任何入学申请材料给国科大。中国科学院—发展中国家科学院院长奖学金计划需提交的申请材料以其申请办法为准。/Applicant should send this admission application form along with the following required documents by mail to the relevant institute/faculty. None of the application documents will be returned. Please DO NOT send to UCAS the application package without the supervisor’s signature and official stamp of the institute /faculty. The application procedure for CAS-TWAS President's Fellowship is different, and the application documents shall be submitted in accordance with the Call for Application for CAS-TWAS President's Fellowship released to public.
(ⅰ)最高学位证书公证件原件/Original of the notarized photocopy of highest degree certificate
(ⅱ) 大学本科或研究生学习成绩单公证件原件/Original of the notarized photocopy of transcripts of your undergraduate or graduate study
(ⅲ) 两名副教授以上学者的书面推荐信（原件）/Two original recommendation letters either in Chinese or English issued by associate professors or higher, or scholars with equivalent academic titles
(ⅳ) 个人简历/Curriculum vitae
(ⅴ) 研究计划/Research proposal (in Chinese or English)
(ⅵ) 已发表的主要论文、著作及作品首页及摘要/Photocopy of the title page of published academic papers, writing & art works including the abstract
(ⅶ) 普通护照身份页复印件/Photocopy of the ID page of regular passport
(viii) 报名费交纳凭证/Remittance receipt of the application processing fee