Committee of 100 Leadership Scholarship Application Form
百人会英才奖申请表
只供研究生参加 For Graduate Students Only
缺项的申请表无效,申请人将可能被取消申请资格.All sections of this application must be completed, otherwise applicant may be disqualified.
申请截止日期为2008年12月8日.All required documents must be submitted before 2008 December 8th.
1 申请人基本情况/Personal Information
申请人姓名
中文:
Chinese:
(姓)
(Surname)

(名)
(First Names)

英文:
English:
(姓)
(Surname)

(名)
(First Names)

性别:
Sex:

年龄:
Age:

出生日期:
Date of Birth:
年/ 月/ 日
Year/Month/Day
当前联系地址:
Present Address:

联络电话:
Telephone:

电子邮件:

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