LaXin Academy of Fite Arb.Chnu邮政编码：110004 地址：中国 辽宁省沈阳市和平区三好街 19 号 Postcode : 110004 Add: No. 19. Sanhao Street, Hoping District, Shenyang ・ ChinaTEL:+86-24-2393-0108 FAX:+86-24-2393-9750 留学生入学申请表AppIication From for Overseas Students1.中文姓名Chinese Name：2.国籍 Nat i onaIity：照片 Photo3.英文姓名EnglishName：4.性另IJ Gender5.出生日期 年 月 日Birth Date： Y M D6.宗教信仰 Re Iigion：7.出生地点 8.护照号码 9.婚姻状况Place of Birth： Passport No： Mar ital Status：10.通讯地址 邮箱Present Add: Emai:11•永久地址 Permanent Add:12.请按时间先后顺序填写本人中/高等学历Please List in Chronological Order Your Middle /High Education学校School/University在校时间(自・••至・・・) Durat ion (from/to)所获证书/学位 Diploma/Degree Received主修专业 Field of study13.汉语熟练程度(很好/好/—般/初级)Chinese Prof iciency (ExceI I Ient/Good/Fai r/Beginning) 阅读 会话 书写Reading Speaking Writing14.留学类型(请在下面选项中选择)Studying Program (Please choose as indicated be Iow)口本科生 口硕士研究生 口进修生 口交换生B. A/B. SC. M. A/M. SC. Advanced Student Change Student15.请说明来鲁迅美术学院学习/研究的主要目的 Please specify your study/research in LAFA16.在鲁迅美术学院学习计划 Describe your study/schedule in LAFA as fo11ows(1) 专业 Field of Study：(2) 学习期限 Duration of Study：Fm /Y /M /D To /Y /M /D17.请注明你在鲁迅美术学院学习/研究经费来源Please specify the source of your financial suppor for your study in LAFA请附上由指导过你的教授(或学校校长、系主任)出具的两封推荐信 请列出他们的姓名、职务、职称和地址Please submit two recommendation letters by the professors under whom You have studied (or the university president, department head) Please Iish their name. position/ titles and addresses 担保Guarantee书申请人姓名：性别：国籍：Name of AppIicat ion:Gender:Nat i onaIity:姓名Name职务/职称 Position or itle地址 Address19•是否曾在华学习或工作过？如果是，请说明，并注明时间If you have studied or worked before in China, please give detaiIs and date.20. X作简历 Working Exper inces日期Date工作单位 Employer职位职称 Position or Title21•在华联系人的名字、地址和号码Name > address and teleph one nu mber of your refere nee in China to be not i f i ed in case of emergencyo姓名 Name地址ADD TED.申请人保证：I hereby affirm that:(1) 上述各项中所提供的情况真实无误。
What fill in this form is totally true and correct(2) 在鲁迅美术学院期间，遵守中国政府的法律和学校的规章制度I shalI abide by the laws of the Chinese government and the regulations of LAFA during my stay in LAFA・申请日期 申请人签名Date : Signature:申请日期 申请人签名Date : Signature:我愿意作以上申请人在鲁迅美术学院学习期间的担保人，如果该生在鲁迅美术学院学习期间出现任 何意外或经济问题，我将负全部责任I hereby guaran tee to be responsible to the above appl icarrt s behavior and finance during the per iod of his/her studying in LAFA・ Should there be an emergency or financial problem occurred to him/her, I will be duty bound to take my responsibiIity for it.保证人姓名 Name of Guarantor:国籍 NationaI ity:Tel： Fax：地址ADD：日期Date:保证人签字 Signature of Guarantor:。