孔子大学总部国家汉办

孔子学院总部/国家汉办
Confucius Institute Headquarters (Hanban)
地址：北京市西城区德胜门外大街129号
Add EN：129 Deshengmenwai Street, Xicheng District, Beijing, China
邮政编码:(Post code):100088
电话(Tel): +86-010-********;传真(Fax):+86-010-********
电邮(Email):
第十二届“汉语桥”世界大学生中文比赛选手推荐表
Recommendation Form for the 12th "Chinese Bridge"-Chinese Proficiency
Competition for Foreign College Students
中文姓名/Name(in Chinese, if applicable):
护照用名(英文)/Passport Name(in English)
照片姓/Family Name:
名/Give Name:
以下内容请用中文填写(带*号项除外)/Please Fill in the Blanks in Chinese except with *:
出生日期/Date of Birth:
出生地点/Place of Birth:国家/Country: 城市/City
国籍/Nationality: 护照号码/Passport No:
护照有效期/Expired date of Passport:
男/Male: 女/Female:已婚/Married:未婚/Single:
宗教信仰/Religion:
是否有特殊饮食要求/Any special food requirements?
第一语言/First Language 第二语言/Second Language
家庭成员华文背景/Chinese Background of Family Members:
电话/Tel: 传真/Fax:
电子邮件/E-mail:
*永久通讯地址(请用英文填写)/Mailing Address (in English):
受教育情况/Education Background:
学校在校时间主修专业毕业证书及学位证书
Institutions Years Attended Fields of Study Certificates Obtained or to Obtain
是否曾在孔子学院学习/Have you ever studied in Confucius Institute？: 是/Yes: 否/No:
若是，请写出该孔子学院名称/If your answer is yes,writer down the name of the Confucius Institute：
学习汉语的时间/Period of Chinese leaning:
自拟演讲题目/Topic of prepared speech:
准备表演的中国文化技巧/Prepared performance of Chinese culture skills:
个人特长介绍/Personal Strengths Introduction:
如果你能持续晋级，可否全程参加2013年7月初到8月初在中国进行的复赛、决赛？/If you could pass every promotion competition, could you participate in the semi and final competitions in China successively to the end from early of July to early of August, 2013?
可以/Yes:
不可以/No: 可停留至/Until:(日期/Date)
选手本人签字/Signature of the applicant: 日期/Date:
护照扫描件
Scanned Passport
(注意:中国籍人员请
扫描所在国永久居留
证)
( Note: A scan
version of permanent
residence
certificate granted
by the host country
is required for
Chinese applicants)
以下栏目由中国驻外使(领)馆教育(文化)处(组)填写(For official use only)
中国驻外使(馆)教育(文化)处(组)意见/Comments of the Embassy or Consulate of P.R.China:
驻使(馆)教育(文化)处(组)
签字盖章/Official Signature: 日期/Date:。