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1、附件7：长期高层次外专个人信息采集表PersonaIInformationForm(P1easefi11inEng1ish)姓(如护照所示)SURNAME(AsinPassport)名(如护照所示)FIRSTANDMIDD1ENAMES(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SpecificP1ACEOFBIRTH(Country,StateZProvince,City)eg.China,AnhuiProvince,HefeiCi1y国籍NATIONA1IT
2、Y婚姻状况MARITA1STATUSMarriedDivorcedBereftofonesspouseSing1e宗教信仰RE1IGIOUSBE1IEF护照类型Dip1omaticOService(Officia1)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PROFICIENCYOFOTHER1ANGUAGE申请人现全职工
3、作单位APP1ICANTFU11-TIMEJOBEMP1OYERPRESENT1Y申请人现全职工作地点(国家/地区)APP1ICANTFU11-TIMEJOB1OCATIONPRESENT1Y(countrydistrict)申请人现全职工作岗位APP1ICANTFU11-TIMEJOBOCCUPATIONPRESENT1Y申请人现全职工作所属行业APP1ICANTFU11-TIMEJOB申请人现全职工作职务或职称APP1ICANTFU11-TIMEJOBTIT1E申请人电话APP1ICANTTE1EPHONEINDUSTRYCATEGORYPRESENT1YPRESENT1YNUMBER申请
4、人主要突出成就MajorAchievementsoftheapp1icant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Fi11edinbytheemp1oyer.邀请单位联系人联系电话INVITINGUNITCONTACTPERSONTE1EPHONENUMBER聘请单位填写Fi11edinbytheemp1oyer.邀请单位联系人联系邮箱INVITINGUNITCONTACTPERSONE-MAI1ADDRESS聘请单位填写Fi11edinbytheemp1oyer.适用外
5、国高端人才具体标准APP1ICAB1ESTANDARDFORFOREIGNHIGH-ENDTA1ENTS聘请单位填写Fi11edinbytheemp1oyer.是否持有境外职业资格证书；如有，请列出名称和编号HAVEYOUEVEROBTAINEDANYPROFESSIONA1QUA1IFICATIONCERTIFICATEABROAD?Ifyes,p1ease1isttheNAMEANDNUMBEROFPROFESSIONA1QUA1IFICATIONCERTIFICATES国籍国工作电话OfficePhoneatyourhomecountry电子邮箱E-MAI1ADDRESS列出所有曾授予你
6、护照的国家1ISTA11COUNTRIESTHATEVERISSUEDYOUAPASSPORT列出所有曾使用过的护照号码1ISTA11passportNUMBERSTHATYOUEVERHAVEUSED与任职相关工作经验RE1ATEDWORKINGExperienceand1engthOFWORKINGTIME办理签证地ThespecificChineseEmbassyorConsu1atewhereyouwi11app1yforvisa拟入境日期Schedu1edDateofEntryintoChina申请在华工作起止时间intentedworkingtimeinchina(yyyy-mm-
7、dd)聘请单位填写(ThiSsectionsha11befi11edinbytheemp1oyer)每年在华工作时间(月)WORKINGTIMEINCHINAPERYEAR(months)聘请单位填写(ThiSsectionsha11befi11edinbydieemp1oyer)是否毕业于世界知名大学？如是，请列出。IFYOUAREGRADUATEDFROMWOR1DRENOWNEDUNIVERSITIES?Ifyes,p1snameit.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DOYOUHAVEANYEXPERIENCEINWOR1DTOP500COMPANIESfWE11
8、-KNOWNFINANCIA1INSTITUTIONSOR1AWFIRMS?在上述单位曾担任最高职务HIGHESTPOSITIONYOUHAVEEVERHE1DINAFOREMENTIONEDORGANIZATIONS是否入选中国国内相关人才计划IFYOUARESE1ECTEDASACANDIDATEOFANYCHINASTA1ENTP1AN公认职业成就RECOGNIZEDPROFESSIONA1ACHIEVEMENT在中国工作任务JOBDESCRIPTIONINCHINA聘请单位填写(ThiSsectionsha11befi11edinbytheemp1oyer)列出曾就读的高等教育学校(含
9、职业教育学校，如无高等教育经历，请填写最高学历)1isA11highereducationa1institutionsyouHaveattented(inc1udingvocationa1institutions)名称NAME所在国家(Country,State/Province,City)就读时间desOfattendance(yyyy-mmti11yyyy-mm)专业SPECIA1ITY教育类型Educationa1type学位ACADEMICQUA1IFICATIONEg:AnhuiUniversityeg.China,AnhuiProvince,HefeiCityeg.2016/9/1
10、-2017/7/30eg.Eng1ish1iteratureeg.Fu11-timeeg.Bache1orsdegree列出曾工作的单位(近十年内)11STA11EMP1OYERSYOUHAVEWORKEDFORIN1ASTTENYEARS名称NAME工作所在国家SPECIFICP1ACE(Country,StateZProvince,City)起止时间DATES(yyyy-mm-ti11yyyy-mm)工作岗位OCCUPATION职务JOBTIT1E工作任务JOBDESRIPTIONEg:AnhuiUniversityeg.China,AnhuiProvince,HefeiCityeg.20
11、16/9/1-2017/7/30eg.Teachereg.1ecturereg.Eng1ish1anguageteaching随行家属情况ACCOMPANYINGFAMI1YMEMBERS是否有家属随行DOYOUHAVEANYACCOMPANYINGMEMBER(1ega11ywedspouseorchi1drenunder18)?人数NUMBEROFTHEACCOMPANYINGMEMBERS随行家属姓名NAME(AsinPassport)出生日期DATEOFBIRTH(yyyy-mm-dd)性别GENDER国籍NATIONA1ITY与申请人关系RE1ATIONSHIPTOTHEAPP1IC
12、ANT护照号码PASSPORTNUMBER在华紧急联系人EMERGENCYCONTACTTE1EPHONENUMBER与申请人关系RE1ATIONSHIPTOTHEAPP1ICANT电子邮箱E-MAI1ADDRESS电子邮箱E-Mai1addresS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,AMNESTYOROTHERSIMI1AR1EGA1ACTION?口是YES否Ne)您是否曾感染过对
13、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？HAVEYOUeverbeenaff1ictedWITHACOMMUNICAB1EDISEASEOFPUB1ICHEA1THSIGNIFICANCEORADANGEROUSPHYSICA1ORMENTA1DISORDER?是YES否NO您是否曾违反中国法律，被中国政府递解出境？是YESHAVEYOUEVERVIO1ATEDTHE1AWOFCHINA,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
14、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。ISO1EMN1YPROMISETHATIHAVENOCRIMINA1RECORDBOTHATMYHOMECOUNTRYANDABROAD.WHENIARRIVEINCHINA,IWI11STRICT1YABIDEBYTHECHINESE1AWS.ICERTIFYTHATA11THEANSWERSTOTHISAPP1ICATIONANDRE1EVANTATTACHMENTSTOITARETRUEANDCOMP1ETED.IFTHEINFORMATIONISFOUNDTOBEUNTRUEORUNCOMP1ETED,IAMAWARETHATINEEDTOUNDERTAKECORRESPONDING1EGA1RESPONSIBI1ITIES.!UNDERSTANDTHATA11OFTHEINFORMATIONINTHISAPP1ICATIO
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