南华大学国际学生学习申请表

NO.___________________________

中国 421001 湖南省衡阳市市常胜西路 28 号 此处无需填写(Do not write in this space)

International College, University of South China
Hengyang, Hunan 421001, China
Tel: +86-734-8281975, Fax: +86-734-8281976
E-mail:enroll@usc.edu.cn

南华大学国际学生学习申请表
International Student’s Application for Study in University of South China
申请人信息 The Applicant’s Information

姓/Family Name:
FATIMA
姓名
Name

名/Given Name: MUFFARAH

男 Male □ 单身 Single ∎
婚姻状况
国籍 性别
PAKISTANI Marital 已 婚 Married
Nationality Sex 女 Female ∎ Status □

出生日期
年 月 日 出生地点
Date of PAKISTAN
1998 01 28 Place of Birth
Birth
健康状况 文化程度
一般 Average □ 宗教信仰
Health ISLAM Education UNDERGRADUATE
好 Good ∎ Religion
Status Level
护照号码
护照有效期 年 月 日
Passport FZ8457961
Valid until 2018 11 30
No.
 MALIK’S HARDWARE
通讯地址
TRAFFIC CHOCK 电话 Tel +923175410717
Mailing
OPP.MAKKAH PLAZA 邮箱 E-mail Ijlalmalik193@gmail.com
Address
TALAGANG CHAKWAL

家庭住址
Home WARD# 7 NEAR MASJID ALLAH-HO MOHALLAH SHARAK TALAGANG CHAKWAL
Add.
学生申请类 语言进修生 Chinese Language Student□ 本科生 Undergraduate ∎
别
Student 研究生 Postgraduate □
Status
学习期限：自 年 月至 年 月 学习专业:
Duration: From 2017 11 to 2023 11 Field of Study : CLINICAL MEDICINE (MBBS)

申请人教育背景 The Applicant’s Educational Background

本人简历（从高中开始）/Curriculum vitae (Starting from high school)
单位 时间（年月——年月） 职务
Previous and current education ＆ Duration(from/to) Position
employer
Gateway international school Talagang 2012 TO 2014 A
(Matriculation)
Punjab group of collage 2014 TO 2016 A
(intermediate pre-medical)
Foundation student December 2017 To May
2018
现有汉语水平 /Current Chinese Language Proficiency (Mark the following option about how
many Chinese characters you have grasped)
A. about 200 ∎ B. about 600 C .about 1000 D. over 2000 E. None
现有英语水平 / Current English Proficiency
A. Native ∎ B. Fluent C. Communicable D. Poor

学习经费来源 /Sources of Funding for the Study

∎自费 /Self-Supporting □奖学金/Scholarship □其他/Other

推荐人信息 The Reference’s Information

姓名/Full Name RANA TAYYAB 职业/Occupation BUSINESS 电话/Tel +923167159633

推荐人承诺 The Reference’s Statement

I hereby verify that the information provided by the applicant about his/her educational background is true and
authentic.

Signature: Date: 28-07-2018

申请人家庭信息 The Applicant’s Family Information

家庭情况/Family information and family members

姓名 与申请人关系/ 职 电话和电子邮件/ 家庭年收入/
/Name Relationship with 业 /professi Tel.& E-mail Annual household
the applicant on income

NASEER FATHER BUSINESS- A.USD＄8000-10000 □

AHMAD MAN Tel: +923005780705 B.USD＄10000-15000∎
E- C.USD＄15000-20000□
mail:muffarahfatima289 D.USD＄20000-30000□
@gmail.com E.Above USD＄30000□

SHAHIDA MOTHER HOUSE Tel: +923005780705

NASEER WIFE E-mail:

BROTHER STUDENT Tel:

SACHAL E-mail:
ABBAS

家人经济担保证明 The Family’s Statement of Financial Support

I hereby promise that I and my family have fully understood the prospective cost for and have the
capacity to support the applicant to finish his/her educational program in the University of South China and
will pay all fees timely and adequately.

Name ( in printed style) : NASEER AHMED

Relationship with the applicant FATHER

Signature Date : 28-07-2018

申请人声明 The Applicant’s Statement

申请人保证 I hereby affirm that:

1. 上述各项中所提供的情况真实无误。
All the information I provided above is true and correct.
2.在华学习期间遵守中国的法律和学校的规章制度。
I shall abide by the laws of China Government and regulations of the University of South China.
3.按时交纳学校规定的各种费用。
I will pay all the expenses prescribed by the university on time.
申请人签名： 日期： 年 月 日

Signature: Date: 2018 07 28