教授接收外国留学生意向表

Form for Provisional Acceptance of International Student by USTC Professor

此表由接收导师填写，接收院系盖章，然后将扫描版发给申请人，申请人需要在网申系统里上传。
This page is to be filled in by the applicant’s supervisor and institute/school, and send back to applicants, who
need to upload the scanned copy in the application system.

申请人姓名 申请人国籍
Applicant’s Name Nationality
□本科生(Undergraduate)
邮箱 拟接收类别 □硕士生(Master)
Email Level of Study □博士生(PhD)
拟接收专业 拟接收系别
Major Department
学习期限 授课语言 □汉语 Chinese
Duration of Study Language of Instruction □英语 English
导师姓名 导师联系电话及邮箱
Supervisor’s Name Supervisor’s Telephone No.& Email
导师意见（非常重要，请导师经邮件、电话或视频对申请者进行评估后，如实填写意见。）（Supervisor’s
comments. VERY IMPORTANT.）：

导师签字 (Signature)：
年(year) 月(month) 日(day)
研究所/院系意见 (Comments of the Institute/ School)：

负责人签字 (Signature)： （单位公章/ Official Seal）

年(year) 月(month) 日(day)
注：本表由我校教授填写；根据与外国学生沟通了解的情况，提出接受意向。本表不作为留学生的录取凭证。外国留学生可将本表作为申请
的辅助材料递交给留学生招生部门。
Note：This form is filled by the professor of USTC according to his knowledge of the applicant. This form cannot be used
as an official letter of admission; it can only be used as a supplementary part of the application materials for study
at USTC.