中文Chinese Name

性别

Sex

国籍

Nationality

出生日期

Date of Birth

出生地

Place of Birth

婚姻状况

Marital Status

护照号码

Passport No.

职业

Current Occupation：

现工作学习单位Employer or Institution Affiliated:

永久通讯地址

Permanent Mailing Address

宗教Religion

电话

Tel.

电子邮件

E-mail

留学类别Application Categories

□ 语言进修生Chinese Language Students □ 本科生Undergraduate

□ 硕士研究生Postgraduate (Master) □ 博士研究生PHD

学历（自高中后）

Educational Background（From High School）

校名 在校时间 证书、学位 专业

Name of School Date of Attendance Diploma or Degree Major

在何处学过多长时间汉语？

Where and how long have you studied Chinese?

程度如何 Language Ability

Ž Beginning Ž Fair Ž Good Ž Excellent

母语

Native Language

其它语言

Proficiency in

Other Languages

预备学习的专业及年限

Major(s) to take and planning duration (from M/Y to M/Y)

1.

2.

3.

在华事务担保人信息

Information of the guarantor(s) in China in case of emergency

姓名 地址 电话号码

Name Address Tel/Cell Phone

签字(Signature):

申请人保证：

1. 上述各项中所提供的情况是真实无误的；

2. 在中国学习期间将遵守中国政府的法律和学校的规章制度。

3. 在学学习期间出现任何意外或经济问题，将由担保人负全部责任。

I hereby certify that:

1. All the information given in this form is true and correct;

2. I shall abide by the laws of China and the rules and regulations of Lanzhou University of Technology;

3. Should there be any emergency or financial problems occurred, my guarantor(s) in China will take the responsibilities.

签名： 日期：

Signature： Date：

Chinese language learning Program

Application materials required:

1. Application Form for Admission;

2. Two copies of the page with personal information the passport and eight passport-sized photos;

3. Completed “Physical Examination Report for Foreigner” with original copies of ECG and Blood Test Report;

4. Notarized photocopy of your highest educational level diploma/certificate;

5. Non-refundable application fee: RMB 400.0.

Note: The documents provided should be the original in Chinese or English; otherwise notarized translations in Chinese or English are required.

Undergraduate’s Program

Application materials required:

1. Application Form for Admission;

2. Notarized photocopy of High School Diploma;

3. Applicant who is in school or in-service work need to submit school certificate of enrollment or certificate of employment;

4. Notarized photocopy of Academic Report;

5. Study plan (at least 200 words);

6. Two copies of the page with personal information of the passport and eight passport-sized photos;

7. Completed “Physical Examination Report for Foreigner” with original copies of ECG and Blood Test Report;

8. HSK transcript;

9. Applicant who is under the age of 18 need to submit the legal documents of the legal guardians in China;

10. Non-refundable application fee: RMB 400.0

Note: The documents provided should be the original in Chinese or in English, otherwise notarized translations in Chinese or English are required. Applicants with no command of Chinese are generally required to take Chinese language courses and obtain HSK Certificate before their major studies.

Master/PHD’s Program

Application materials required:

1. Application Form for Admission;

2. Application Form for Chinese Government Scholarship;

3. Notarized photocopy of Bachelor/Master Degree Diploma;

4. Applicant who is in school or in-service work need to submit school certificate of enrollment or certificate of employment;

5. Notarized photocopy of Academic Report;

6. Study plan (at least 800 words);

7. HSK transcript and two academic recommendation letters from scholars of associate professorship or higher;

8. Two copies of the page with personal information the passport and eight passport-sized photos;

9. Completed “Physical Examination Report for Foreigner” with original copies of ECG and Blood Test Report;

10. Non-refundable application fee: RMB 400.0

Note: The documents provided should be the original in Chinese or in English, otherwise notarized translations in Chinese or English are required. Applicants with no command of Chinese are generally required to take Chinese language courses and obtain HSK Certificate before their major studies.

Application Procedure and Instruction

The new academic year begins in September. Applicants are asked to send the completed Application Form before the end of June for the new academic year or before the end of December for the Spring semester that starts in February of the following year.

1. Applicants must send to Lanzhou University of Technology along with the completed Application Form and other materials specified above.

2. After receiving the application materials by the date specified above, the recruiting committee in the school will review the application materials and select applicants for further interview. The applicants selected will be notified in advance, and then we will send the applicant the Visa Application Form (JW202) and Admission Notice.

3. By submitting the Visa Application Form for Study in China (JW202) and Admission Notice along with the completed “Physical Examination Report for Foreigner”, the admitted applicants should apply to the Chinese Embassy (or Consulate) for the study visa (Application for X Visa is required of any applicant whose study time in China is over 6 months).

4. The student is required to register at International Office of Lanzhou University of Technology during the time specified in Admission Notice and apply for Residence Permit within 30 days after arriving in China. The student shall be fined by the local Public Security Bureau if he fails to do so within the said period.