西北工业大学境外学生返校知情同意书

西北工业大学国际教育学院：
我叫 ，学号： ，国籍：
。我将于 月 日乘坐 次航班自 （城
市）飞往 （城市），返回中国。
鉴于目前全球疫情尚未结束，为确保平安返校，我将
自觉遵守中国法律法规，严格遵守出入境隔离及疫情防控
政策。
返校过程中，我郑重承诺：
1. 自愿接受中国疫情防控相关要求，包括但不限于：
1）自愿负担返校及疫情防控产生相关费用（机票费用
+隔离住宿费用+隔离期间餐费+核酸检测费用+闭环转运交
通费用）；
2）积极配合在完成中国境内的核酸检测工作。
2. 入境内前接种不少于两次新冠疫苗。
3. 严格遵守中国各地（包括入境地、目的地）的疫情
防控管控要求。
4. 入境返校全程与学校密切联系。
5. 不在网上发布入境返校相关信息。
6. 如因未履行承诺或故意隐瞒健康状况造成未能返校
后果，由本人承担全部责任。
 以上信息本人知情且同意。
签名：
日期：

Northwestern Polytechnical University Informed Consent Form Of

International Students Returning To School

International College of Northwestern Polytechnical University:

I am ， student Id ， nationality ， I will take

(Flight Number) from (City) to
(City)，back to China.

The global epidemic is not over yet. To ensure successfully entry into China with
good health, I will consciously abide by the laws and the regulations of Covid-19
pandemic prevention in China. I will solemnly promise that:

1. I will accept the all requirements related to Covid-19 pandemic prevention

regulations in China, including.

1) I will willing to pay for the costs related to the epidemic prevention (flight tickets
expenses+ quarantine accommodation expenses + meals fee + nucleic acid testing
costs + transportation costs of closed-loop transfer).

2. I will cooperate with taking all nucleic acid tests in China.

3. I will complete at least two vaccinations of Covid-19 before entering the China.

4. I will abide by the Covid-19 pandemic prevention requirements in any place of

China (including the place of entry and destination).

5. I will not post any related information of returning to school on the Internet.

6. I will keep in touch with school during the journey of returning to school.

7. I will take fully responsible for the consequences of failure of returning to China,
due to deliberately conceal the health condition.
I have informed and agreed with the above information.

Signature:
Date: