南昌理工学院外国留学生入学申请表

APPLICATION FOR ADMISSION TO NANCHANG INSTITUE OF TECHNOLOGY

姓名 姓 Surname : PROTIC 中文名 Chinese Name

Name on Passport 名 Given name : SHEIKH ERFANUL
HAQUE
BANGLADESHI BP0971003 照片 photo
国籍 护照号码
Nationality Passport No.
出生日期 男 Male ☑ 女
年 Y : 1997 月 M : 10
Date of Birth 日 D:06 Female □

出生地点/Place of Birth : SIRAJGANJ 宗教信仰

国家/Country :BANGLADESH 省/province:RAJSHAI 城 市 City:SIRAJGANJ /Religion:
MUSLIM
婚姻状况/ Marital Status 随行家属/ Accompanying Family Member
☑Single □Married □有 Yes □无 No
家庭主要成员/Family members （like your parents or other relatives）
姓名/ Name : MD ABUL HASHAM 关系/ Relationship : FATHER 电话/ Tel.
+8801711156126
家庭详细住址/Home address( Include apartment No., street and number, city, state or province,
postcode and country) : BAHIRGOLA, SIRAJGONJ SADOR, SIRAJGONJ SADOR, SIRAJGONJ

家庭电话 Country code Area code Number 电子邮件

Home Telephone No. +8801711156126 Email Address
HIGH SCHOOL
最后学历/Highest Education 职业/Occupation

现学习或工作单位/ Current
or latest school or employer

学习经历 学校名称 时间 所获证书和专业

(从高中开始)
School Name Duration Diploma/ Certificate and Major

Education
SIRAJGONJ GOVT.B.L HIGH SCHOOL 2011-2012 BUSINESS STUDY
from Senior
High School SIMLA COLLEGE,SIRAJGONJ 2013-2014 BUSINESS STUDY
学习类型/Types of Program
本科生 Bachelor’s Degree ☑ 学习汉语 Chinese Language Study
□ 专业 Major:
学习计划
Study Plan 其他 other:

学习期限/Duration of Study in NIT

自/from 年/year 月/month 至/to 年/year 月/month
 母语 Native Language

语言能力 汉语水平 Present Level of Chinese

Language Excellent □ good □ fair □
Proficiency 英语水平 Present Level of English
Excellent ☑ good □ fair □

其他/Others
学费和生活费来源 奖学金/Scholarship □; 自费/Self-supporting□;
Resource of tuition & living fees 其他/Other□

（担保人可以是父母或亲戚朋友，国籍不限，但学生不能做担保人）Emergency
经济担保人 contact during your stay in NIT (Emergency contact can be your parent, relative & friend
或机构
without the limitation of nationality, but students are rejected)
Financial
support will
姓名/ Name: MD ABUL HASHAM 国籍/ Nationality:BANGLADESHI
be provided
与本人关系/Relationship to the applicant: FATHER
by 永久通讯地址/Address:
SIRAJGONJ
单位/ Name of
employer:BUSINESS
电话/Tel (住宅/home): (办公室/office):
在华担保人
和电话 姓名/Name 联系电话/Phone No.
Guarantor in 单 位 /Employer
China & Tel
联系地址/Address

申请人保证/I hereby affirm:

1. 上述情况真实无误。I have reviewed the above information, and it is true and
complete to the best of my knowledge.
2. 在中国学习期间遵守中国政府的法律和学校的规章制度。I shall abide by the laws of
the Chinese government and the regulations of the University.

申 请 人 签 字 /Signature 日 期 /Date