中文姓名Chinese Name：

性別Gender：

□男 Male

□女 Female

國(guó)籍:

Nationality：

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Photo

英文姓名(與護(hù)照一致) English Name(the same as the passport)：

證件類型 Type of ID Certificate：

證件號(hào)碼 ID Certificate NO.：

最高學(xué)歷 Highest Degree Granted：

出生日期 Birth of Date：

畢業(yè)院校及所學(xué)專業(yè) Graduation University and Major：

申報(bào)單位 Employer：

實(shí)習(xí)崗位Internship Position：

實(shí)習(xí)時(shí)間Days of Internship:           天(Days)

申報(bào)單位聯(lián)系人 Contact Person of Employer：

聯(lián)系人手機(jī) Mobile Phone Number：

國(guó)內(nèi)住址 Add. in China：

電子郵箱E-mail：

國(guó)內(nèi)手機(jī)號(hào)碼 Mobile Phone Number in China：

國(guó)外手機(jī)號(hào)碼 Mobile Phone Number in Home Country：

國(guó)外住址 Add. in Home Country：

主要工作經(jīng)歷（ Work Experience）：

時(shí)間（Time ）      國(guó)家（Country）      單位（ Employer）       職務(wù)（Position ）

主要教育經(jīng)歷從本科填起（ Educational Experience  Start from Bachelor Degree）：

時(shí)間（Time ）   國(guó)家（Country）     院校（University）    專業(yè)（Major）    學(xué)位（Degree）

個(gè)人專長(zhǎng)及代表性成果（Field of Specialty and Representative Achievements ）：

實(shí)習(xí)計(jì)劃Plan of Internship:

本人鄭重承諾，在本國(guó)及境外無犯罪記錄，來華后將嚴(yán)格遵守中國(guó)法律法規(guī)，自覺服從聘用單位各項(xiàng)管理制度。本申請(qǐng)表上所做之回答均屬事實(shí)且詳盡，所附材料真實(shí)、有效，若所提交的內(nèi)容被發(fā)現(xiàn)不實(shí)或不詳，本人愿意承擔(dān)全部法律責(zé)任。對(duì)所提交的全部申請(qǐng)信息和附件授權(quán)可以調(diào)查，包括我的工作經(jīng)歷、教育經(jīng)歷和無犯罪記錄等。

I SOLEMNLY PROMISE THAT I HAVE NO CRIMINAL RECORD BOTH AT MY HOME COUNTRY AND ABROAD. WHEN I ARRIVE IN CHINA AND START TO WORK, I WILL STRICTLY ABIDE BY THE CHINESE LAWS AND REGULATIONS, AND CONSCIOUSLY OBEY THE MANAGEMENT SYSTEM OF THE EMPLOYING INSTITUTION. I CERTIFY THAT ALL THE ANSWERS TO THIS APPLICATION AND RELEVANT ATTACHMENTS TO IT ARE TRUE AND COMPLETED. IF THE INFORMATION IS FOUND TO BE UNTRUE OR UNCOMPLETED, I AM AWARE THAT I NEED TO UNDERTAKE CORRESPONDING LEGAL RESPONSIBILITIES.I UNDERSTAND THAT ALL OF THE INFORMATION IN THIS APPLICATION AND DOCUMENTS SUBMITTED WITH THIS APPLICATION MAY BE CHECKED BY RELEVANT PARTIES, INCLUDINGMY EMPLOYMENT, WORK PERFORMANCE,ABILITIES,EDUCATION,PERSONAL EXPERIENCES AND CONVICTION RECORDS.I CONFIRM THAT, IF I AM OVER SIXTY YEARS OLD,I WILL APPLY FOR MEDICAL INSURANCE COVERAGE AS ARE NEEDED DURING MY WORK PERIOD IN CHINA.

申請(qǐng)人簽名SIGNATURE OF APPLICANT

日期DATE(yyyy-mm-dd)

本單位同意接收該外國(guó)學(xué)生實(shí)習(xí),并承諾如實(shí)向行政機(jī)關(guān)提交有關(guān)材料和反映真實(shí)情況，對(duì)申請(qǐng)材料實(shí)質(zhì)內(nèi)容的真實(shí)性負(fù)責(zé),承擔(dān)相關(guān)法律責(zé)任。

THE EMPLOYER HEREBY DECLARES THAT ALL THE DOCUMENTS AND INFORMATIONS SUBMITTED TO THE AUTHORITY ARE TRUE,AND SHALL BE RESPONSIBLE TO THE AUTHENTICITY OF THE DOCUMENTS AND UNDERTAKE CORRESPONDING LEGAL RESPONSIBILITIES.

單位公章（Seal of Employer） 年 月    日

YYYY     MM    DD