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大连东软信息学院留学生入学申请表
DALIAN NEUSOFT UNIVERSITY OF INFORMATION
APPLICATION FORM FOR INTERNATIONAL STUDENTS
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申请人信息/Applicant Information
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姓名/Name in Full:姓/Family name:名/Given name:
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国籍/Nationality:出生国家（地区）/Country of Birth:母语/Mother Language:
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出生日期/Date of birth:性别/Gender:
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婚姻状况/Marital Status:宗教/Religion:
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护照号码/Passport No.:签发日期/Date of Issue:
有效期限/Date of Expiry:
签发地点/Place of Issue:
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现住址/Present address:
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电话/Tel: 传真/Fax: 邮箱/E-mail:
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申请人学习经历/Applicant Education Background（从高中学历起/From high school）
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时间/MMYY-MMYY国家/Country学校名称/Name of Institution所获学位/Degree
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申请人工作经历/Applicant Working Experience
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时间/MMYY-MMYY国家/Country公司名称/Name of Company证明人/Reference
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申请人语言水平/Applicant Language Level
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以前汉语学习经历/Experience of Previous Chinese Learning:

□无/No □6个月以下/Less than 6 months □6个月至1年/6 months to 1 year □1年以上/More than 1 year
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汉语水平/Chinese Proficiency:

□零基础/Entry Level □初级/Elementary □中级/Intermediate □高级/Advanced HSK____级（或其它汉语水平资格： ）
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英语水平/English Proficiency:

□母语/Native Language □零基础Entry Level □初级Elementary □中级Intermediate □高级Advanced 英语水平资格/Certificate:
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申请人学习计划/Applicant Study Plan
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申请专业或项目/Which program do you apply?
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计划在华学习时间/Intended Length of Study:
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（20 年/y 月/m 日/d— 20 年/y 月/m 日/d）
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申请理由・目的/Reason(s) for applying：
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学习目标及计划/Learning Objectives and Plan：
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申请人家庭成员/Family Members of Applicant
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与申请人的关系/Relation to the Applicant姓名/Name联系方式/Tel邮箱/E-mail职业/Occupation地址/Address
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父亲/Father
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母亲/Mother
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配偶/Mate
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子女/Children
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其他/Others
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在华事务担保人/Guarantor for applicant staying in China:
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姓名/Name: 与申请人的关系/Relation to the Applicant:
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工作单位/Employer: 职业/Occupation:
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电话/Tel:传真/Fax:
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邮箱/E-mail: 邮件地址/Postal address:
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紧急联络人/Emergency Contact:
□在华事务担保人/Guarantor in China
□其他/Others：
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姓名/Name: 与申请人的关系/Relation to the Applicant:
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电话/Tel:传真/Fax:
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邮箱/E-mail: 邮件地址/Postal address:
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经费担保人或机构/Financial Sponsor or Institutions:
□在华事务担保人/Guarantor in China
□本人/In Person
□机构/Institutions
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机构名称/Name of Institutions: 联系人/Reference:
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联系方式/Tel:邮箱/E-mail:
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□亲属/Relatives
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姓名/Name: 与申请人的关系/Relation to the Applicant:
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工作单位/Employer: 职业/Occupation:
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邮箱/E-mail: 电话/Tel:
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申请人相关信息/Applicant Related Information
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是否有犯罪记录/Illegal Records:

□是，请详细说明/Yes,please specify：
□否/No
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疾病及过敏史/Disease and Allergy History:
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其他需要说明的事项/Other Matters That Need to be Explained:
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录取通知书领取方法/How to collect the Admission Notice:

□邮寄 现住址/Deliver to the present address
其他地址/Other address_________________
□到校领取/Collect at Dalian Neusoft University of Information
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申请材料清单/Supporting Documents for Application
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□经济证明/Financial proof
□推荐信/Recommendation letter
□在读证明或毕业证明/Studying certificate or Graduation certificate
□成绩单/Transcript
□健康证明/Proof of applicant health condition
□电子版照片/Electronic ID photo		□纸版照片/Paper ID photos
□护照首页扫描件/Photocopy of passport pages
□HSK证书复印件/HSK certificate
□无犯罪记录证明/Certificate of no criminal conviction
□未成年人海外留学监护人委托书/Letter of Authority issued by the parents of applicant under 18

*如提供请勾选/Tick in the box if submitted
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申请人承诺/Applicant Acknowledgement
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申请人保证/I hereby affirm that:

1)上述各项中填写的信息和提供的材料真实无误。如因个人信息错误、失真造成不良后果，责任由本人承担。
All information and materials provided are factually true and correct. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation or expulsion, should the information I’ve certified be false.

2)在华期间，遵守中国的法律和法规，不从事任何危害中国社会秩序的，与本人来华学习身份不相符合的活动；
During my stay in China, I shall abide by the laws and decrees of the Chinese government, and will not participate in any activities which are deemed to be adverse to the social order in China and are inappropriate to the capacity as a student;

3)在学期间，遵守学校的校纪校规，尊重学校的教学安排。
 During my study in China, I shall observe the rules and regulations of the university, and will concentrate on my studies, and will follow the learning arrangements provided by the university.
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申请人本人签字/Signature of the applicant: 申请人监护人签字/Signature of the applicant's guadian:



*申请人不满18周岁时监护人也需要签字/The guardian also needs to sign when the applicant is under 18 years old
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日期/Date:　
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录取结果/Admission Result
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招生人员审核结论/Review result:
(Written by university admissions officer)		审核人/Reviewer:
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日期/Date:　
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来华留学管理信息系统备案结果：
(Written by university admissions officer)		经办人/Reviewer：
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日期/Date:　
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