南京理工大学来华留学生语言生申请表 LANGUAGE STUDENT APPLICATION FORM FOR INTERNATIONAL STUDENTS NANJING UNIVERSITY OF SCIENCE AND TECHNOLOGY(NUST) 护照用名/Name in passport 姓/Family name 中文名 Chinese name 照片 Photo 名/Given name 国籍 Nationality 出生地点 Place of birth 出生日期 Date of birth 年月日 /year /month /date 男□Male 女□Female 已婚□Married 未婚□Single 护照号码 Passport No. 宗教 Religion 最高学历/Highest Diploma 学****期限: 年月至年月 Duration: from mo. yr. to mo. yr. 永久通讯地址/Permanent mailing address: 电话/Tel: 传真/Fax: E-mail: 目前通讯地址/Current address if different: 电话/Tel: 传真/Fax: E-mail: 推荐单位/How did you learn about this program? 语言水平/Level of language Chinese □ none □ minimal □ conversational □ fluent English □ none □ minimal □ conversational □ fluent 已学****汉语学时。/I have studied Chinese for hours. of passport □本人已附护照复印件/I have enclosed a copy of my passport. (不退还)/Application fee (non-refundable) □网上已支付订单号Paid Order ID of Application fee (RMB 500) from online payment system for international students of NUST : ________________ members 姓名/ Name 关系/ Relation 职业/ Employment 电话/ Tel: ______________ ______________ __________________ ______________ ______________ ______________ __________________ ______________ ______________ ______________ __________________ ______________ 我愿意到南京理工大学学****在校学****期间保证做到下列各项/I am willing to study at Nanjing University of Science