香港中文大学（深 圳）.doc

香港中文大学(深圳)
THE CHINESE UNIVERSITY OF HONG KONG, SHENZHEN
供应链与物流管理高级管理人员理学硕士课程
EMSc Programme in Supply Chain and Logistics Management
报名表
Application Form
个人资料Personal Particulars
姓名必须与身份证档所列相同 The name given below should be the same as that printed on your identity document
中文姓名Name in Chinese:________________ 中文电码(如适用) (if any):______________
英文姓氏 Surname in English :______________ 英文名字 Given name in English:____________________
性别 Gender:o 男Male o 女Female
出生日期Date of birth:____/____/____ (日/月/年 dd/mm/yy)
国籍Nationality:_______________________ 出生地Place of origin:____________________
户籍(只适用于内地申请者) Family register (for Mainland applicants only):__________________
身份证号码(如适用) Identity Card no.:___________________________
若您不是中国身份证持有者,则请提供您的护照号码。若获得录取,需在注册时出示此文件原件以核实身份。If you do not have a Chinese Identity Card, please provide your passport number. If you are admitted, you MUST present the same document for verification of your identity during registration.
护照号码Passport No.:___________
通讯地址(中文) Correspondence address in Chinese:
联络电话号码Contact phone number(s) : __________________(住宅 Home) ___________________(手机Mobile)
电邮地址 E-mail address:_______________________ _ 微信号:
学历Academic Qualifications
颁发院校及国家
Awarding university and country
文凭/学位
Dip/Degree
主修/副修
Major/Minor subject
修读模式*
Mode of study*
修课地点
Location of study
修课日期
Date of