河西学院留学生“一带一路”沿线国家校长专项奖学金
申请表
（供申请入学的外国留学生申请奖学金用）
Foreigner's Application Form for The President’s Scholarships of Hexi University
(For International Students Applying for Admission to Hexi University)
1. 申请人基本情况/Personal Information of the Applicant
护照用名 Passport Name |
姓 名 Surname Given Names |
中文名 Chinese Name |
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性别 Gender |
□ 男 □女 Male Female |
国籍 Nationality |
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护照号码 Passport No. |
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出生日期 Birth Date |
年/月/日 Year/Month/Day |
出生地点 Birth Place |
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当前联系地址 Present Address |
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联系电话 Tel |
|
传真 Fax |
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电子邮件Email |
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QQ/ MSN |
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永久通信地址 Permanent Address |
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2. 申请学习类别和专业/The Program to Which the Applicant is Applying for Admission
申请学习类别 Program to Apply for |
□ 语言进修生Chinese Language Student □ 专科生 Junior College Students □ 本科生Undergraduate |
申请学习专业 Major |
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申请学习院系 Departments/Schools |
本栏可空缺 (This column can be vacant) |
3. 申请奖学金类别/Type of Scholarships
申请人在河西学院大学学习期间的费用来源 Financial Support for Your Study at Hexi University □自费 □本国政府奖学金 □公司或机构 □ 派遣大学 Self Government of Home Country Company or Agency Home University □其他（请说明） Others (Details required) ____________________ _____________________ |
申请奖学金类别 Type of Scholarships for which You are Applying □ A类 One Year Tuition Free: RMB14，000元（Undergraduate），RMB10，000元（Chinese Undergraduate） □ C类 Excellent Student: 一等奖4，400元、二等奖2，800元、三等奖1，600元 First Prize RMB 4，000, Second Prize RMB2，800, Third Prize RMB1，600 注：奖学金不以现金方式支付，直接减免获奖学年内学费的相应金额。 Note: Scholarships are not payable in cash, award will be directly deducted from the amount of tuition of the corresponding school year. |
4. 申请奖学金的相关材料/Supporting Information for Scholarship Application
* This part can be carried over to next page.
获奖励情况和特长 Academic Honors and Distinctions |
专业学习或研究经历 Research and Profession Experience |
已发表的代表性论著或作品 Publications and Innovations |
5. 申请人保证/I Hereby Affirm that:
(1) 填写的上述内容和提供的材料真实无误；
All the information and materials given in this form are true and correct;
(2) 若获得奖学金资助，将按照规定履行岗位职责。
Once Approved, I shall fulfill the responsibility of the Scholarship positions.
*填表时请参照《河西学院“一带一路”沿线国家留学生校长专项奖学金实施办法（暂行）》
*Please refer to “President Scholarship” for International Students Study in Hexi University (HXU) when fill in this form.
申请人签字
Signature of the Applicant ________________________
日期
Date of Signature (Year/Month/Date) ________________________