长期高层次外专个人信息采集表.docx

附件7：长期高层次外专个人信息采集表PersonaIInformationForm(PleasefillinEnglish)姓(如护照所示)SURNAME(AsinPassport)名(如护照所示)FIRSTANDMIDDLENAMES(AsinPassport)别名或曾用名（英文）OTHERNAMEUSED中文姓名ChineseName性别GENDER出生日期DATEOFIRTH(yyyy-mm-dd)出生地SpecificPLACEOFBIRTH(Country,StateZProvince,City)eg.China,AnhuiProvince,HefeiCily国籍NATIONALITY婚姻状况MARITALSTATUSMarriedDivorcedBereftofone'sspouseSingle宗教信仰RELIGIOUSBELIEF护照类型DiplomaticOService(Official)Ordiniiry护照号码PASSPORTTYPEPASSPORTNUMBER护照签发日期ISSUANCEDATE(yyyy-mm-dd)护照有效期至EXPIRATIONDATE(yyyy-mm-dd)最高学历/学位Highestacademicdegree汉语水平CHINESEPROFICIENCY是否掌握其他语言PROFICIENCYOFOTHER1.ANGUAGE申请人现全职工作单位APPLICANTFULL-TIMEJOBEMPLOYERPRESENTLY申请人现全职工作地点(国家/地区)APPLICANTFULL-TIMEJOBLOCATIONPRESENTLY(countrydistrict)申请人现全职工作岗位APPLICANTFULL-TIMEJOBOCCUPATIONPRESENTLY申请人现全职工作所属行业APPLICANTFULL-TIMEJOB申请人现全职工作职务或职称APPLICANTFULL-TIMEJOBTITLE申请人电话APPLICANTTELEPHONEINDUSTRYCATEGORYPRESENTLYPRESENTLYNUMBER申请人主要突出成就MajorAchievementsoftheapplicant邀请单位名称NAMEOFINVITINGUNIT安徽大学AnhuiUniversity邀请单位联系人INVITINGUNITCONTACTPERSON聘请单位填写Filledinbytheemployer.邀请单位联系人联系电话INVITINGUNITCONTACTPERSONTELEPHONENUMBER聘请单位填写Filledinbytheemployer.邀请单位联系人联系邮箱INVITINGUNITCONTACTPERSONE-MAILADDRESS聘请单位填写Filledinbytheemployer.适用外国高端人才具体标准APPLICABLESTANDARDFORFOREIGNHIGH-ENDTALENTS聘请单位填写Filledinbytheemployer.是否持有境外职业资格证书；如有，请列出名称和编号HAVEYOUEVEROBTAINEDANYPROFESSIONALQUALIFICATIONCERTIFICATEABROAD?Ifyes,pleaselisttheNAMEANDNUMBEROFPROFESSIONALQUALIFICATIONCERTIFICATES国籍国工作电话OfficePhoneatyourhomecountry电子邮箱E-MAILADDRESS列出所有曾授予你护照的国家1.ISTALLCOUNTRIESTHATEVERISSUEDYOUAPASSPORT列出所有曾使用过的护照号码1.ISTALLpassportNUMBERSTHATYOUEVERHAVEUSED与任职相关工作经验RELATEDWORKINGExperienceandlengthOFWORKINGTIME办理签证地ThespecificChineseEmbassyorConsulatewhereyouwillapplyforvisa拟入境日期ScheduledDateofEntryintoChina申请在华工作起止时间intentedworkingtimeinchina(yyyy-mm-dd)聘请单位填写(ThiSsectionshallbefilledinbytheemployer)每年在华工作时间(月)WORKINGTIMEINCHINAPERYEAR(months)聘请单位填写(ThiSsectionshallbefilledinbydieemployer)是否毕业于世界知名大学？如是，请列出。IFYOUAREGRADUATEDFROMWORLDRENOWNEDUNIVERSITIES?Ifyes,plsnameit.是否曾在世界500强企业、知名金融机构或律师事务所等任职DOYOUHAVEANYEXPERIENCEINWORLDTOP500COMPANIESfWELL-KNOWNFINANCIALINSTITUTIONSOR1.AWFIRMS?在上述单位曾担任最高职务HIGHESTPOSITIONYOUHAVEEVERHELDINAFOREMENTIONEDORGANIZATIONS是否入选中国国内相关人才计划IFYOUARESELECTEDASACANDIDATEOFANYCHINA'STALENTPLAN公认职业成就RECOGNIZEDPROFESSIONALACHIEVEMENT在中国工作任务JOBDESCRIPTIONINCHINA聘请单位填写(ThiSsectionshallbefilledinbytheemployer)列出曾就读的高等教育学校(含职业教育学校，如无高等教育经历，请填写最高学历)1.isALLhighereducationalinstitutionsyouHaveattented(includingvocationalinstitutions)名称NAME所在国家(Country,State/Province,City)就读时间desOfattendance(yyyy-mmtillyyyy-mm)专业SPECIALITY教育类型Educationaltype学位ACADEMICQUALIFICATIONEg:AnhuiUniversityeg.China,AnhuiProvince,HefeiCityeg.2016/9/1-2017/7/30eg.EnglishLiteratureeg.Full-timeeg.Bachelor'sdegree列出曾工作的单位(近十年内)1.1STALLEMPLOYERSYOUHAVEWORKEDFORINLASTTENYEARS名称NAME工作所在国家SPECIFICPLACE(Country,StateZProvince,City)起止时间DATES(yyyy-mm-tillyyyy-mm)工作岗位OCCUPATION职务JOBTITLE工作任务JOBDESRIPTIONEg:AnhuiUniversityeg.China,AnhuiProvince,HefeiCityeg.2016/9/1-2017/7/30eg.Teachereg.Lecturereg.EnglishLanguageteaching随行家属情况ACCOMPANYINGFAMILYMEMBERS是否有家属随行DOYOUHAVEANYACCOMPANYINGMEMBER(legallywedspouseorchildrenunder18)?人数NUMBEROFTHEACCOMPANYINGMEMBERS随行家属姓名NAME(AsinPassport)出生日期DATEOFBIRTH(yyyy-mm-dd)性别GENDER国籍NATIONALITY与申请人关系RELATIONSHIPTOTHEAPPLICANT护照号码PASSPORTNUMBER在华紧急联系人EMERGENCYCONTACTTELEPHONENUMBER与申请人关系RELATIONSHIPTOTHEAPPLICANT电子邮箱E-MAILADDRESS电子邮箱E-MailaddresS您是否由于犯有任何罪行而曾经被逮捕或被判有罪，即使后来得到了赦免或收回等其他类似措施？HAVEYOUEVERBEENARRESTEDORCONVICTEDFORANYOFFENSEORCRIME,EVENTHOUGHSUBJECTOFAPARDON,AMNESTYOROTHERSIMILARLEGALACTION?口是YES否Ne)您是否曾感染过对公共健康有影响的传染病或患过可造成危险的身体疾病或精神病？HAVEYOUeverbeenafflictedWITHACOMMUNICABLEDISEASEOFPUBLICHEALTHSIGNIFICANCEORADANGEROUSPHYSICALORMENTALDISORDER?是YES否NO您是否曾违反中国法律，被中国政府递解出境？是YESHAVEYOUEVERVIOLATEDTHELAWOFCHINA,ANDDEPORTEDFROMCHINA?否NO本人郑重承诺，在本国及境外无犯罪记录，来华后，将严格遵守中国法律法规。本申请表上所做之回答均属事实且详尽，所附材料真实、有效，若所提交的内容被发现不实或不详，本人愿意承担法律责任。对所提交的全部申请信息和附件授权可以调查。ISOLEMNLYPROMISETHATIHAVENOCRIMINALRECORDBOTHATMYHOMECOUNTRYANDABROAD.WHENIARRIVEINCHINA,IWILLSTRICTLYABIDEBYTHECHINESELAWS.ICERTIFYTHATALLTHEANSWERSTOTHISAPPLICATIONANDRELEVANTATTACHMENTSTOITARETRUEANDCOMPLETED.IFTHEINFORMATIONISFOUNDTOBEUNTRUEORUNCOMPLETED,IAMAWARETHATINEEDTOUNDERTAKECORRESPONDINGLEGALRESPONSIBILITIES.!UNDERSTANDTHATALLOFTHEINFORMATIONINTHISAPPLICATIONANDdocumentsSubmittedwiththisapplicationmaybecheckedbyrelevantparties.申请人签名SIGNATUREOFAPPLICANT日期DATE(yyyy-mm-dd)邀请单位承诺如实向行政机关提交有关材料和反映真实情况，并对申请材料实质内容的真实性负责,承担相关法律责任。THEINVITINGUNITHEREBYDECLARESTHATALLTHEDOCUMENTSANDINFORMATIONSSUBMITTEDTOTHEAUTHORITYARETRUE,ANDSHALLBERESPONSIBLETOTHEAUTHENTICITYOFTHEDOCUMENTSANDUNDERTAKECORRESPONDINGLEGALRESPONSIBILITIES.聘请单位填写(ThiSsectionshallbefilledinbytheemployer)邀请单位公章(Sealofinvitingunit)年月曰YYYYMMDD