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中国国家留学生基金管理委员会 CSC

NO.
CHINA SCHOLARSHIP COUNCIL 派遣类别: 学生类别:
中国 北京西城区车公庄大街9号A3楼13层 100044
Level 13, Building A3, No.9 Chegongzhuang Avense Beijing 经费办法: 学习专业:
100044 P.R China
Tel:0086-10-66093900 E-mail:laihua@csc.edu.cn
Fax:0086-10-66093915 Http://www.csc.edu.cn

( The above table is only for CSC )

A P P LICATION FOR M FOR CHINE SE G OVE R NME NT


SCHOLA R SHIP

Personal Information
Agency No. Agency Name
10561 South China University of Technology

Surname Given Name


SULTAN MD TIPU

Chinese Name Gender


Male

Date of Birth Marital Status


1986-11-21 Married

Nationality Native Language Passport No. Date of Expiration


Bangladesh Other BJ0242548 2031-01-18

Country of Birth City of Birth Religion


Bangladesh Kushtia Islam

Personal Contact Phone Personal Contact Email Personal Contact Alternate Email
+8801718956226
No. engrtipukhan@gmail.com tipu.electrical@palmalgarments.com

Personal Contact WeChat ID Personal Contact SKYPE No.


wxid_yqjdvvtqfttu22 Engr Tipu

Personal Contact Correspondence Address


House#43, Flat #5A,Road#12,Sector#10,Uttara,Dhaka,Bangladesh.

Emergency Contact Name Emergency Contact Gender


Md.Anisur Rahman Male

Relation to the Applicant


Sibling

Emergency Contact Phone No. Emergency Contact Email


+8801844512266 engrtipukhan@gmail.com

Emergency Contact Correspondence Address


House#31,Road #10,Bashundhara Residential Area,Block#F,Dhaka,Bangladesh.

Serial Number: 212EBF1721 Page 1 of 6 Generated: 2021-03-23


Education and Employment History
Highest/Current Education
Education Level
Bachelor's Degree

Country of the Institute Institute Name


Bangladesh AIUB

Years Attended Field of Study


2006-01-02 -- 2009-11-01 Electrical Engineering

Qualification (eg. BA. BSc)


BSc

Other Education CertificatesⅠ


Education Level
Senior High School

Country of the Institute Institute Name


Bangladesh Kushlibasha Secondary School

Years Attended Field of Study


1997-01-02 -- 2002-04-02 Science

Qualification (eg. BA. BSc)


SSC

Other Education CertificatesⅡ


Education Level
Other

Country of the Institute Institute Name


Bangladesh Jhenaidah Govt K.C College

Years Attended Field of Study


2002-03-02 -- 2005-05-04 Science

Qualification (eg. BA. BSc)


HSC

Employment History
Employer
Palmal Group Of Industries

Employment Duration Work Engaged


2020-09-09 -- 2021-03-21 Maintenance Work

Title & Position


AGM,Maintenance

Serial Number: 212EBF1721 Page 2 of 6 Generated: 2021-03-23


Language Proficiency and Study Plan
Chinese Proficiency Whether holding a HSK certificate or not?
Poor No

Level of Obtained HSK Certificate Score Obtained Test Date

English Proficiency Whether holding a certificate of English proficiency?


Good No

Name of the Test Score Obtained Test Date

Apply as Discipline Applying For


Master's Degree Engineering

Preferred Teaching Language Major Applying for


Chinese Electrical Engineering

Duration of Major Study


2021-09-01 -- 2024-07-15

Ever studied or worked in China?


No

Institute or Employer Employment Duration


--

Ever studied in China under a Chinese Government Scholarship?


No

Institute Name Employment Duration


--

Serial Number: 212EBF1721 Page 3 of 6 Generated: 2021-03-23


Other Contacts
Name of Contact Person or Organization in China Tel
Rocky +8618816812263

E-mail Fax
rocky@hanglorygroup.com 0755-2321

Address
NO.322 Yuanhu Road,Longgang District,Shenzhen China.

Spouse's Name
Mahabuba Khanum

Spouse's Age Spouse's Occupation


32 Banker

Father's Name
Md Manser Ali Khan

Father's Age Father's Occupation


58 Businessman

Mother's Name
mamataj Khatun

Mother's Age Mother's Occupation


52 Housewife

Serial Number: 212EBF1721 Page 4 of 6 Generated: 2021-03-23


◆ Supporting Documents
✓ Passport/Visa Style Photo;

✓ Certificates of Highest Education (Notarized Copy):


Bachelor's Degree Master's Doctor's Other

✓ Transcripts of Highest Education (Notarized Copy);


✓ Study Plan;

✓ Reference Ⅰ;
✓ Reference Ⅱ;

✓ Passport Home Page;


✓ Physical Examination Record for Foreigner;

Articles or Papers Written or Published;


Examples of Art(6 color pictures)and Music(1 audio tape)Work(Only for the applicants applying for Fine Arts and
Music);

Chinese Language Proficiency Certificate;


English Language Proficiency Certificate;

✓ Non-Criminal Record Report (If the applicant is unable to provide this document, as a substitute, the applicant
could negotiate with the applied university to sign a non-criminal record commitment);
Other Attachments(List Needed): 。

Note: All supporting documents uploaded must be clear scanning copies of the original documents. Each Set of the
complete materials should not exceed 20 pages.Please use DIN A4.

◆ I Hereby Declare That:


All information and supporting documentation provided for this application are complete, true and correct;

During my stay in China, I shall abide by the laws and decrees of the Chinese government, and will not participate in
any activities in China which are deemed to be adverse to the social order of China and are inappropriate to the
capacity as a student;

I will agree to the arrangements of my institution and specialty of study in China made by CSC,and will not apply for
any changes in these two fields without valid reasons;
During my study in China, I shall abide the rules and regulations of the host university, and concentrate on my studies
and researches, and follow the teaching programs arranged by the university;

I shall go through the procedures of the Annual Review of Chinese Government Scholarship Status as required;
I shall return to my home country as soon as l complete my scheduled program in China, and will not extend my stay
without valid reasons;

If I am judged by the Chinese laws and decrees and the rules and regulations of the university as having violated any of
the above, I will not lodge any appeal against the decision of CSC on suspending, or withdrawing my scholarship,or
other penalties。

Serial Number: 212EBF1721 Page 5 of 6 Generated: 2021-03-23


Statement of Applicant

China Scholarship Council (CSC)


Thank you for using the Chinese Government Scholarship Information System. Before proceeding, please read the
terms and conditions carefully. If you do not agree with any of the terms and conditions, you may choose not to submit
your application. You (the applicant) should be aware that by submitting this application, you will have consented to
the terms and conditions, regardless of the application’s final result.
1. Each applicant will be issued a username and password by the CSC after they have completed the registration
process. The applicant is fully responsible for the username and password. The applicant will be liable for activities
and events carried out under this account.

2. The applicant is fully responsible for the authenticity, legality, validity and accuracy of all the information contained
within the application. The applicants must not impersonate others and must not include any information in the
application that does not belong to them. The applicants will be unable to edit the application after the submission.
Any false or misleading information contained in the submitted application will negatively influence the scholarship
application and the applicant will be responsible for the corresponding consequences.
3. Each scholarship awardee cannot partake in more than one Chinese government provided scholarship program
during his/her study period in China. If an awardee is to have breached this rule, the CSC reserves the right to cancel
the scholarship that might already have been awarded to him/her.

4. In the circumstance that the applicant is refused by all three preferred universities of Type A application, CSC will
do its best to arrange another Chinese university to enroll the applicant. Applicants that still can not be admitted
after this process will lose the scholarship opportunity.
5. Within each enrollment year, each applicant is allowed submit no more than 5 applications, including a maximum
of 2 Type A and 3 Type B applications.

6. Terms of Privacy: User privacy is one of the CSC’s most valued principles. The CSC will strive to protect the private
information of applicants through technical, management and other measures. Once the application is submitted, the
applicants agree that the relevant data contained in the application will be provided to the dispatching authorities and
universities, for the purposes of their admissions and studies.
✓ I confirm that I have read and accept the CSC’s “Statement of Applicant”.

Serial Number: 212EBF1721 Page 6 of 6 Generated: 2021-03-23

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