Harbin Medical University Application Form for International Students

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哈尔滨医科大学外国留学生入学申请表

Harbin Medical University Application Form for International Students

(Please type or print)

护照用名/Name in Passport:

Family Name:                 Given Name:

中文姓名/Name in Chinese, if applicable:

照片/Photo

性别

Sex

婚姻状况

Marital Status

国籍

Citizenship

宗教信仰

Religion

出生日期    年 月 日

Date of Birth Year Month Date

出生地点

Place of Birth

护照号码

Passport No.

有效期至    年 月

Valid Until   Year Month

最后学历及获得时间

Highest Education Level and the date obtained or to obtain

当前学习或任职单位

Currently Institution Enrolled/Employed

职业

Occupation

E-mail:

目前联系地址及电话/Current Mailing Address & Tel

永久通讯地址及电话/Permanent Mailing Address & Tel

受教育情况/Education Background

在校时间

Years Attended

学 校

Institutions

专 业

Fields of Study

学 位

Certificates

工作经历/Employment Record

起止时间

Time（from/to）

工作单位

Employer

从事工作

Work Engaged

职务

Position

申请学习类别/Program applied for:

MBBS (English medium, 6-year program) □

Master□；Doctor□；Postdoctoral□；Training□

International students, who will study in Chinese language, need to pass HSK certificate level 3—6.            

汉语水平         很好□     好□      一般□     差□  不会□

Chinese Proficiency Excellent    Good      Fair        Poor   None

申请人亲属情况/Family Members

姓名/Name

职业/ Occupation

电话/Tel.

父亲/Father

母亲/Mother

配偶/Spouse

申请人保证/I hereby affirm that

1.申请表中所填写的内容和提供的材料真实无误的。

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

2.在华期间，遵守中国的法律法规，不从事任何危害中国秩序的、与本人来华学习身份不相符的活动。

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 the social order in China and inappropriate to the capacity as a scholar or student.

3.在学期间，遵守学校的校规校纪，全力投入学习和研究工作，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 researches, and will following the teaching programs made by the university.

4.按时交纳各项费用。

I will pay the fees on time.

5. 由于新冠肺炎疫情，我将按照中国的入境防疫政策办理入境手续，并联系招生办公室了解更多信息。新生也有可能以在线教育的形式开始课程。

Due to COVID-19 pandemic, I will follow China's entry and quarantine policy to complete entry formalities and contact the Admissions Office for more information. There are possibilities for new students to start the program in the form of online education.

日期/Date：                 申请人签字/Applicant’s signature：                             

1. ◆若无签字，则视为无效申请/ The application is invalid without the applicant’s signature.

申请人签字/Signature:                               日期/Date:

邮寄地址:                                     Mailing Address:

邮政编码 150081                               College of International Education

中国黑龙江省                                  Harbin Medical University

哈尔滨市南岗区保健路157号                    157 Baojian Road Nangang District

哈尔滨医科大学国际教育学院                    Harbin China, 150081

电话:86-451-87086250                           Tel：86-451-87086250

传真:86-451-87086250                          Fax：86-451-87086250    

Email: cie@ems.hrbmu.edu.cn                     Email: cie@ems.hrbmu.edu.cn 

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