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北京培黎职业学院

英文姓

Family Name 

英文名

Given Name

照

片

Photo

工作单位Employer

起止日期Time (from-to)

从事工作Work Engaged

职位Position

汉语/Chinese：   □ 很好/Excellent   □ 较好/Fair   □ 差/Poor    □ 不会/None

HSK 考试等级（如果有请填写）/Level   of HSK Test（If    appropriate）：               级

爱好： □ 打篮球    □ 踢足球    □ 唱歌   □ 跳舞    □ 其他              

Hobbies:playing basketball, playing   football,singing, dancing, other

姓名 Name

年龄 Age

职业 Occupation

电话 Tel

E-mail

姓名 Name

职业Occupation

工作单位 Employer

电话 Tel

E-mail

　I   hereby affirm that:

(1) All   the information above I provided is true and correct.

(2) I   shall abide by the laws and decrees of the Chinese government. I have read   and understood Notes to International Students and I shall observe all the   rules and regulations of the University. Besides, I shall pay all the   expenses on time.

(3) Students will take the responsibility if damages occur   because of the following situations:

●   Students break the rules and regulations of the University;

● Students or some groups organize activities without the   authorization of the University;

● Students take   part in studying, training, experiments, internship, practice and other group   activities approved by departments but don’t follow the rules and regulations;

● Students refuse to correct their dangerous behaviors   in spite of the persuasion from the University;

● Students hide their special body constitution,   special illness or abnormal psychological state from the University;

● Other damages caused by students’ family problems or students themselves;

● Students constitute a crime;

● Students commit suicide or hurt themselves;

● Damages occur during non-working days like the   holiday or on leave as well as during time away without permission;

● Irresistible and inevitable incidents like the   earthquake, lightning stroke, typhoon and flood take place.

● Sudden and incidental accidents outside the school   cause the damage.