中文姓名Chinese Name：

性別Gender：

□男 Male

□女 Female

國籍 Nationality:

照    片

Photo

英文姓名(與護照一致) English Name(the same as the passport)：

證件類型 Type of ID Certificate：

證件號碼 ID Certificate NO.：

最高學歷 Highest Degree Granted：

出生日期 Birth of Date：

畢業(yè)院校及所學專業(yè) Graduation University and Major：

國內住址 Add. in China：

電子郵箱E-mail：

國內手機號碼 Mobile Phone Number in China：

國外手機號碼 Mobile Phone Number in Home Country：

國外住址 Add. in Home Country：

擬在津畢業(yè)實習及創(chuàng)新創(chuàng)業(yè)時間Planning Period of Internship and Entrepreneurship in Tianjin:

年(Year)      月(Month) 至(to)          年(Year)       月(Month)

主要工作經歷（ Work Experience）：

時間（Time ）      國家（Country）      單位（ Employer）       職務（Position ）

主要教育經歷從本科填起（ Educational Experience  Start from Bachelor Degree）：

時間（Time ）   國家（Country）     院校（University）    專業(yè)（Major）    學位（Degree）

個人專長及代表性成果（Field of Specialty and Representative Achievements ）：

實習計劃(Plan of Internship):

本人鄭重承諾，在本國及境外無犯罪記錄，在天津畢業(yè)實習或創(chuàng)新創(chuàng)業(yè)期間將嚴格遵守中國法律法規(guī)，自覺服從聘用單位各項管理制度。本申請表上所做之回答均屬事實且詳盡，所附材料真實、有效，若所提交的內容被發(fā)現不實或不詳，本人愿意承擔全部法律責任。對所提交的全部申請信息和附件授權可以調查，包括我的工作經歷、教育經歷和無犯罪記錄等。

I SOLEMNLY PROMISE THAT I HAVE NO CRIMINAL RECORD BOTH AT MY HOME COUNTRY AND ABROAD. WHEN I ARRIVE IN CHINA AND START TO WORK, I WILL STRICTLY ABIDE BY THE CHINESE LAWS AND REGULATIONS, AND CONSCIOUSLY OBEY THE MANAGEMENT SYSTEM OF THE EMPLOYING INSTITUTION. I CERTIFY THAT ALL THE ANSWERS TO THIS APPLICATION AND RELEVANT ATTACHMENTS TO IT ARE TRUE AND COMPLETED. IF THE INFORMATION IS FOUND TO BE UNTRUE OR UNCOMPLETED, I AM AWARE THAT I NEED TO UNDERTAKE CORRESPONDING LEGAL RESPONSIBILITIES.I UNDERSTAND THAT ALL OF THE INFORMATION IN THIS APPLICATION AND DOCUMENTS SUBMITTED WITH THIS APPLICATION MAY BE CHECKED BY RELEVANT PARTIES, INCLUDINGMY EMPLOYMENT, WORK PERFORMANCE,ABILITIES,EDUCATION,PERSONAL EXPERIENCES AND CONVICTION RECORDS.I CONFIRM THAT, IF I AM OVER SIXTY YEARS OLD,I WILL APPLY FOR MEDICAL INSURANCE COVERAGE AS ARE NEEDED DURING MY WORK PERIOD IN CHINA.

申請人簽名SIGNATURE OF APPLICANT

日期DATE(yyyy-mm-dd)

本單位同意接收該留學學生畢業(yè)實習（工作），并承諾如實向行政機關提交有關材料和反映真實情況，對申請材料實質內容的真實性負責,承擔相關法律責任。

THE EMPLOYER HEREBY DECLARES THAT ALL THE DOCUMENTS AND INFORMATIONS SUBMITTED TO THE AUTHORITY ARE TRUE,AND SHALL BE RESPONSIBLE TO THE AUTHENTICITY OF THE DOCUMENTS AND UNDERTAKE CORRESPONDING LEGAL RESPONSIBILITIES.

單位公章（Seal of Employer） 年 月    日

YYYY     MM   DD