清华大学访学研究生申请表【模板】

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****大学访学研究生申请表VisitingStudentApplication
GraduateSchoolofTsinghuaUniversity
拟访学时间Academicyearforwhichyouareapplying
□一学年□秋季学期□春季学期□其它
YearFullacademicyearFalltermonlySpringtermonlyOthers
FromtoYearMonthDateYearMonthDate
请清楚地填写或打印以下内容Typeorprintlegibly
1.姓名Fulllegalname
(请勿使用缩写,圈出姓氏。Usenoinitials.Circleyourfamilyname.
2.目前通讯地址Currentmailingaddress
有效期至Gooduntil
3.电子邮件地址Emailaddress4.联系电话Telephonenumbers5.永久通讯地址Permanentmailingaddress
联系电话Telephonenumber6.性别Gender:男MaleFemale
7.出生日期Birthdate8.民族Nationality
9.身份证号/护照号IDcardnumber/Passportnumber10.婚姻状况Maritalstatus:已婚Married未婚Single
11.目前就读学校Theuniversitywhereyouarestudying学生身份Currentstatus:硕士master’sstudents博士doctoralstudents主修专业Major平均学分积GPA

12.曾经就读学校Universitieswhereyoustudied
学校名称就读时间获得学位主修专业NameofuniversityTimeofstudyDegreeawardedMajor13.健康状况Healthcondition:健康HealthyYesNo14.母语Nativelanguage15.汉语水平Chineseproficiency
很好ExcellentGood一般Average陌生Belowaverage16.英语水平Englishproficiency
Good一般Average陌生Belowaverage
17.工作/实习经历(3个月以上)Workexperience/internship(over3months
工作单位Workplace工作时间Time职位Post
18.资助来源Fundingsource(s
19.是否曾在清华学习过HaveyoueverstudiedinTsinghuaUniversity?
YesNo
以何种身份在清华学习Ifyes,wereyouavisitingstudentoraregularstudent?访学生Visitingstudent正式学生Regularstudent20.访学计划Programofstudy
具体院系Departmentaffiliation
院系名称Nameofdepartment学科Discipline
课程学习Coursework研究Research课程学习Coursework研究Research其它Others
21.选课计划Proposedplanofstudy
(请注明拟选课程名称和课号Pleaseindicatethetitlesandnumbersofthose
coursesyouhopetotake

选课院系School/department课程名称Coursetitle

22.访学目的Statementofpurpose
(请详细说明访学期间的学习和研究计划及访学目的。如需要可另附页说明。Pleaseelaborateyourplanandpurposefor***additionalpagesifnecessary.
本人在此声明以上提供的信息真实、完整、准确。
Iherebycertifythattheinformationprovidedonthisapplicationisaccurate,complete,andhonestlypresented.
申请人签名Signature日期Date


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