出生日期

Date of birth

年/year 月/month 日/date

出生地点

Place of birth

国 籍

Nationality

已婚□Married

未婚□Single

护照号码

Passport No.

性别 男□Male

/Sex 女□Female

最后学历

Previous education

现职业

Occupation

宗教

Religion

现工作单位

Current employer:

联系地址/Mailing address:

电话/Tel: 传真/Fax: E-mail:

来我校学习专业和期限/Intended

field of study & duration in CUIT

从/From 年/year 月month

到/to 年/year 月month

现有汉语水平/Present level of mandarin

Check the appropriate box to indicate the number of Chinese words you know.

A None B 1,000-2,000 C 2,000-3,500 D 3,500-5,000 E over 5,000

本人简历/Curriculum vitae

单位/List previous and current education 时间（年月——年月） 职务

& employer /years attended(from/to) /Position

住宿要求/Accommodation requirement

A.学校安排/Arranged by the University□ B.自已安排Arranged by yourself□

来校留学类别/Program applied for:

Please check the box to indicate the degree or certificate program you are applying for.

□ □ 专科生/Professional Student

□ □ 本科生/Undergraduate Student

□ □ 硕士研究生/Graduate Student

□ □ 博士研究生/Ph.D. Candidate

□ □ 普通进修生/Student for Advanced Studies

□ □ 高级进修生/Senior Student for Advanced Studies

□ □ 研究学者/Visiting Scholar

□ □ 短期生/Short-term Student

□ 语言学习生/Chinese Language Student

详见成都信息工程学院留学生招生简章，如需要可来函索取。

Please seeCHENGDU UNIVERSITY OF INFORMATION TECHNOLOGY Admission Brochure for International Studentsfor details. The brochure will be sent to you on request.

注：来华留学类别确定以后，原则上不再改变，请填写时认真考虑，学业结束，将按填写的留学类别颁发相应的证书。

Please Note: The program choice is basically final. Request for program change is usually unacceptable. Please think carefully before making the choice. You can only get the degree or certificate that is offered by the program you now apply for.

学生保证书

我愿意到成都信息工程学院学习，在校学习期间保证做到下列各项：

1． 遵守中华人民共和国法律。

2． 不从事学习目的以外的活动。

3． 遵守学校的各项规章制度，努力学习。

4． 按时缴纳学校规定的学生应该缴纳的各项费用。

我在校学习期间如发生意外时，请与下面人员联系：

姓名:

国籍:与本人关系:

永久通讯地址:

单位:

电话:(住宅)(办公室)

传真:E-mail:

学生本人签字: 年 月 日

DECLARATION

I am willing to study in Chengdu University of Information Technology. I pledge the following terms during my study:

1. I will abide by the laws of the People’s Republic of China.

2. I will not engage in activities bearing no relation with my academic pursuit in China.

3. I will study industriously and observe all rules and regulations of the University.

4. I will pay all expenses on time.

The following person will be contacted in case of unexpected events or emergencies that may happen to me during my stay in the University.

Name:

Nationality:Relationship to the applicant:

Address:

Name of the employer:

Tel:(home)(office)

Fax:E-mail:

Signature of the student: Date: