西安电子科技大学国际学生学籍异动申请表
Application Form for Student Status Alteration
护照姓名 Passport Name |
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国籍 Nationality |
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学 号 Student Number |
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护照号码 Passport Number |
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出生日期 DOB |
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性别 Gender |
¨女Female ¨男Male |
授课语言 Teaching Language |
¨汉语 Chinese ¨英语 English |
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学院 Major College |
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专业及年级 Major&Grade |
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培养层次 Type |
¨本科生 Undergraduate ¨硕士Master ¨博士PhD ¨语言生Language Student ¨预科生 Preparatory Student |
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手机号码 Mobile |
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邮箱 E-mail |
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西安住宿地址 Address in Xi’an |
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奖学金类别 Scholarship |
¨全额政府奖学金CSC Full Scholarship ¨部分政府奖学金CSC Partial Scholarship ¨其他奖学金 Other Scholarship ¨自费 Self-funding |
政府奖学金号 CSC No. |
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异动类别 Alteration Type |
¨延期Extension 年Year月Month至To年Year月Month ¨休学Suspension 年Year月Month至To年Year月Month ¨退学Drop Out ¨复学 Resuming Study |
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签证到期时间 Visa Expiration Time： |
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申请理由 Reason |
申请人签名Signature: 日期Date： |
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导师意见 Opinion of Supervisor (仅研究生填写For Master&PhD only) |
导师签名Signature: 日期Date： |
培养单位意见Opinion of Major College |
领导签名并盖章: Signature and Official Seal: 日期Date: |
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国际教育处意见 Opinion of Department of International Education |
招生培养办公室意见Opinion of the Office of Admission and Quality Assurance 签名Signature： 日期Date: |
管理服务办公室意见Opinion of the Office of International Student and Scholar Services 签名Signature： 日期Date: |
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领导签名并盖章: Signature and Official Seal: 日期Date: |
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