长期高层次外专个人信息采集表

附件7长期高层次外专个人信息采集表Persona11nformat ion FormPlease fillin English名如护照所示姓如护照所示FIRST ANDMIDDLE NAMESSURNAMEAs in PassportAsinPassport别名或曾用名（英文）中文姓名Chinese NameOTHERNAMEUSED出生日期出生地eg.China.Anhui Province,HefeiCity性别DATE OFIRTH SpecificPLACEOF BIRTHGENDERyyyy-mm-dd Country,Slate/Province,City国籍婚姻状况Married□Divorced□宗教信仰Bereft ofonesspouse□NATIONALITY MARITALSTATUS RELIGIOUSBELIEFSingle□护照类型护照号码Diplomatic□Service Official□Ordinary□邀请单位公章Seal ofinviting unit年月日YYYYMM DDPASSPORTTYPEPASSPORT NUMBER护照签发日期yyyy-mm-dd护照有效期至yyyy-mm-ddISSUANCE DATEEXPIRATION DATE是否掌握其他语言最高学历/学位汉语水平PROFICIENCY OFOTHERHIGHEST ACADEMICDEGREE CHINESEPROFICIENCYLANGUAGE申请人现全职工作地点申请人现全职工作岗申请人现全职工作单位国家/地区位APPLICANTAPPLICANT FULL-TIME APPLICANTFULL-TIMEFULL-TIME JOBJOBLOCATIONJOB EMPLOYEROCCUPATIONPRESENTLYPRESENTLYPRESENTLYcountry/district申请人现全职工作所属行申请人现全职工作职务或申请人电话业APPLICANT职称APPLICANT APPLICANTFULL-TIME JOBFULL-TIME JOB TITLE TELEPHONEINDUSTRYCATEGORY PRESENTLYNUMBERPRESENTLY申请人主要突出成就Major Achievementsof theapplicant邀请单位联系人联系电话聘请单位填写邀请单位名称邀请单位联系人INVITING UNIT安徽大学Filled inby theemployer.聘请单位填写NAME OFINVITING UNITCONTACTPERSONAnhui UniversityFilled inby theemployer.INVITING UNITCONTACT PERSONTELEPHONENUMBER适用外国高端人才具体标邀请单位联系人联系邮箱准APPLICABLEINVITING UNIT聘请单位填写聘请单位填写STANDARD FORCONTACTPERSONFilled inby theemployer.Filled inby theemployer.FOREIGN HIGH-ENDE-MAILADDRESSTALENTS是否持有境外职业资格证书；如有，请列出名称和编号HAVE YOUEVEROBTAINED国籍国工作电话ANYPROFESSIONAL电子邮箱QUALIFICATION CERTIFICATEOfficePhone atyour homeE-MAIL ADDRESSABROADIf yes,please listtheNAMEcountryANDNUMBER OFPROFESSIONALQUALIFICATION CERTIFICATES列出所有曾使用过的护照与任职相关工作经验号码列出所有曾授予你护照的国家RELATED WORKINGLISTALL COUNTRIESTHATLISTALL PASSPORTEXPERIENCEAND LENGTHEVERISSUED YOUAPASSPORTNUMBERS THATYOUEVEROFWORKING TIMEHAVEUSED办理签证地拟入境日期Thespecific ChineseEmbassyorScheduled DateofEntry intoConsulatewhereyou willapply forvisaChina申请在华工作起止时间是否毕业于世界知名大学？每年在华工作时间月如是，请列出IF YOUAREINTENTEDWORKING TIME IN聘请单位填写This sectionWORKINGTIMEIN聘请单位填写This sectionGRADUATED FROMCHINAshall befilledinbytheCHINA PERshallbefilledinbytheemployerWORLD RENOWNEDemployerYEARmonthsyyyy-mm-dd UNIVERSITIESIfyes,plsname it.是否曾在世界强企业、知名500金融机构或律师事务所等任职在上述单位曾担任最高职是否入选中国国内相关人才DOYOU HAVEANY务HIGHEST POSITION计划IF YOUAREEXPERIENCE INWORLD TOP500YOUHAVE EVERHELD INSELECTEDAS ACOMPANIES,WELL-KNOWN AFOREMENTIONEDCANDIDATE OF ANYFINANCIALINSTITUTIONS ORORGANIZATIONSCHINA,S TALENTPLANLAWFIRMS公认职业成就RECOGNIZEDPROFESSIONAL ACHIEVEMENT在中国工作任务聘请单位填写This sectionshall befilledinbytheemployerJOB DESCRIPTIONIN CHINA列出曾就读的高等教育学校含职业教育学校，如无高等教育经历，请填写最高学历LISTALLHIGHEREDUCATIONALINSTITUTIONSYOUHAVEATTESTEDINCLUDINGVOCATIONALINSTITUTIONS就读时间所在国家名称专业教育类型学位DATES OF ATTENDANCECountry,State/Province,NAME SPECIALITYEDUCATIONAL TYPEACADEMIC QUALIFICATIONyyyy-mm till yyyy-mmCityeg.China,Anhui Province,HefeiEg:Anhui Universityeg.2016/9/1-2017/7/3eg.English Literatureeg.Full-time eg.Bachelors degreeCity列出曾工作的单位近十年内LISTALLEMPLOYERSYOUHAVEWORKEDFORINLASTTENYEARS工作所在国家SPECIFIC起止时间DATES名称PLACE职务工作任务yyyy-mm-tillyyyy-mm工作岗位OCCUPATIONNAME Country,State/Province,JOBTITLEJOBDESRIPTIONCityeg.China,Anhui Province.HefeiEg:Anhui Universityeg.2016/9/1-2017/7/30eg.Teacher eg.Lecturer eg.English LanguageteachingCity随行家属情况ACCOMPANYING FAMILYMEMBERS是否有家属随行人数DO YOUHAVE ANYNUMBEROF THEACCOMPANYINGACCOMPANYINGMEMBERlegallywed spouseorMEMBERSchildren under18出生日期与申请人关系随行家属姓名性别国籍护照号码DATEOFBIRTH RELATIONSHIPTO THENAMEAsinPassport GENDERNATIONALITY PASSPORTNUMBERyyyy-mm-dd APPLICANT与申请人关系在华紧急联系人RELATIONSHIPEMERGENCY CONTACTTO THETELEPHONE NUMBERAPPLICANT电子邮箱电子邮箱E-MAILADDRESE-MAIL ADDRESSS您是否由于犯有任何罪行而曾经被逮捕或被判有罪，即使后来得到了赦免或眩回等其他类似措施？HAVE YOUEVER BEEN□是YESARRESTEDOR CONVICTEDFORANYOFFENSEORCRIME,EVEN THOUCOTHER}H SUBJECTOFAPARDON,AMNESTY ORSIMILARLEGAL ACTION□否NO您是否曾感染过对公共健康有影响的传染病或患过可造成危险的身体疾病或常WITH外中病？HAVE YOUEVER BEENAFFLICTED RA□是YESA COMMUNICABLEDISEASE OFPUBLIC HEALTHSIGNIFICANCE CDISORDERDANGEROUS PHYSICALOR MENTAL□否NO□是YES您是否曾违反中国法律，被中国政府递解出境？HAVE YOUEVER VIOLATEDTHE LAWOF CHINA,AND DEPORTEDFROM CHINA□否NO本人郑重承诺，在本国及境外无犯罪记录，来华后，将严格遵守中国法律法规本申请表上所做之回答均属事实且详尽，所附材料真实、有效，若所提交的内容被发现不实或不详，本人愿意承担法律责任对所提交的全部申请信息和附件授权可以调查I SOLEMNLYPROMISE THATI HAVENO CRIMINALRECORD BOTHAT MYHOME COUNTRYAND ABROAD.WHEN IARRIVE INCHINA,I WILLSTRICTLYABIDE BYTHE CHINESELAWS.I CERTIFYTHAT ALL THE ANSWERSTO THISAPPLICATION ANDRELEVANT ATTACHMENTSTO ITARETRUE ANDCOMPLETED.IF THE INFORMATION ISFOUND TOBE UNTRUEOR UNCOMPLETED,I AMAWARE THATI NEEDTOUNDERTAKE CORRESPONDINGLEGAL RESPONSIBILITIES.!UNDERSTAND THATALL OF THEINFORMATIONIN THISAPPLICATION ANDDOCUMENTSSUBMITTEDWITH THISAPPLICATION MAYBE CHECKEDBY RELEVANTPARTIES.申请人签名SIGNATURE OFAPPLICANT日期DATEyyyy-mm-dd邀请单位承诺如实向行政机关提交有关材料和反映真实情况，并对申请材料实质内容的真实性负责,承担相关法律责任THE INVITINGUNIT HEREBYDECLARES THATALLTHEDOCUMENTS ANDINFORMATIONS SUBMITTEDTOTHEAUTHORITY ARETRUE,AND SHALLBERESPONSIBLE TOTHE AUTHENTICITYOFTHEDOCUMENTS ANDUNDERTAKE CORRESPONDINGLEGAL RESPONSIBILITIES.聘请单位填写This sectionshall befilledin bytheemployer。