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7 中国科学院—发展中国家科学院院长奖学金计划申请表
【发布时间:2018-02-08 】 【 】【打印】【关闭

中国科学院与发展中国家科学院院长

奖学金计划申请表

APPLICATION FORM FOR CAS-TWAS PRESIDENT’S FELLOWSHIP PROGRAMME

本页由奖学金申请人逐项认真填写/The applicant shall carefully fill in the following parts.

姓名(同护照用名)/Name (Same as in Passport):

/Family Name /Given Name

性别/Sex ________ 出生日期/Date of Birth ________/Year _______/Month _____ /Day

国籍/Nationality 单位/Current Institution/Employer

学位/Degree awarded 毕业学校/University

毕业时间/Date of Graduation ________/Year _______/Month _____ /Day

 

研究所/院系CAS Institute/ UCAS/ USTC Faculty

学习专业/Research Area

课题名称(经中方导师同意)/Research proposal title (as agreed with host supervisor/tutor in China)

 

奖学金申请期限/Desired Sponsor Period

From ______ /Year /Month /to ______ /Year /Month

Total ______ /Year(s) /Month(s)

如有其它资助,请说明/If funded by other resources during the period of the Fellowship, please specify:

 

学术成果(可另附纸张)

Applicant’s academic publications, honors and awards If needed, please attach an additional sheet.

 

 

 

 

 

本人签字/Signature: _______________ 日期/Date _______/Year ______/Month _____/Day

 

注意事项:/ Note:

请申请人用英文填写本表。This form is to be completed by the applicant in English only.

SUPERVISOR’S COMMENT PAGE

本页由导师和研究所/院系填写,再寄至本奖学金办公室

This page is to be filled in by the applicant’s supervisor and institute/faculty, and then mailed to CAS-TWAS President’s Fellowship Programme UCAS/USTC Office directly by the institute/faculty.

 

研究所/院系Institute/Faculty

申请人姓名

Applicant’s Name

 

申请人国籍

Nationality

 

联系电话

Telephone No.

 

Email

 

导师姓名

Supervisor’s Name

 

职称/职务

Professional Title/Position

 

联系电话

Telephone No.

 

Email

 

导师意见(非常重要,请导师经邮件、电话或视频对申请者进行评估后,如实填写意见。如有往来邮件请附后。)

Supervisor’s comments. VERY IMPORTANT.):

 

 

 

 

导师签字 (Signature)

(year) (month) (day)

研究所/院系意见 (Comments of the institute/faculty)

 

 

 

负责人签字 (Signature)

( 单位公章/ Official Seal

(year) (month) (day)

奖学金评审委员会意见/Comments of the CAS-TWAS President Fellowship Evaluation Committee

 

 

 

评委会主任签字 (Committee Director’s Signature)

(year) (month) (day)

 

 

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