185B82DF0B Application

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CSC Form
  中国国家留学生基金管理委员会 CHINA SCHOLARSHIP COUNCIL 中国   北京西城区车公庄大街 9 号  A3 楼 13 层  100044Level 13, Building A3, No.9 Chegongzhuang Avense Beijing100044 P.R ChinaTel:0086-10-66093900 E-mail:laihua@csc.edu.cnFax:0086-10-66093915 Http://www.csc.edu.cn  Agency No.10200 Agency NameNortheast Normal UniversitySurname ADOWAHGiven NameLUCY MAWUSIChinese Name GenderFemaleDate of Birth1985-10-06Marital StatusSingleNationalityGhanaNative LanguageOtherPassport No.G0677161Date of Expiration2019-01-21Country of BirthGhanaCity of Birth AccraReligionGreater AccraPermanent Contact Tel0242286026Permanent Contact Fax Permanent Contact E-maillm.adowah@gmail.comPermanent Contact AddressP. O. Box KN 2905, Kaneshie-Accra, G/R, GhanaPresent Contact Tel0242286026Present Contact Fax Present Contact E-maillm.adowah@gmail.comPresent Contact AddressP. O. Box KN 2905, Kaneshie-Accra, G/R, GhanaInstitute NameUniversity of Education Years Attended2012-08-01--2015-07-29Field of StudyBiological Science EducationQualification (eg. BA. BSc)BSc CSC NO. 派遣类别: 学生类别:经费办法: 学习专业: ( The above table is only for CSC )  APPLICATION FORM FOR CHINESE GOVERNMENTSCHOLARSHIP Personal Information  :: Education and Employment History  :: Highest Education Page 1 of 4Serial Number: 185B82DF0B Generated: 2018-03-30  Institute Name Years Attended--Field of StudyQualification (eg. BA. BSc)Institute Name Years Attended--Field of StudyQualification (eg. BA. BSc)EmployerEmployment Duration--Work EngagedTitle & PositionChinese ProficiencyNoneLevel of Obtained HSK CertificateEnglish ProficiencyExcellentObtained English Proficiency Certificate Apply asMaster's DegreeDiscipline Applying For V0009Preferred Teaching LanguageEnglishMajor Applying forX0435Duration of Major Study2018-09-03 -- 2020-09-03Ever studied or worked in China?NoInstitute or Employer Employment Duration-- Other Education Certificates ⅠOther Education Certificates ⅡEmployment History Language Proficiency and Study Plan  :: Page 2 of 4Serial Number: 185B82DF0B Generated: 2018-03-30  Name of Contact Person or Organization in China TelE-mail Fax AddressSpouse's NameSpouse's Age Spouse's OccupationFather's NameSamuel AdowahFather's Age80Father's OccupationRetired teacherMother's Name Augustina Attipoe AdowahMother's Age75Mother's OccupationTraderEver studied in China under a Chinese Government Scholarship?NoInstitute Name Employment Duration-- Other Contacts  :: ◆ Supporting Documents :: ✓   证件照片; ✓  Certificates of Highest Education (Notarized Copy) : Bachelor's Degree Master's Doctor's Other ✓  Transcripts of Highest Education (Notarized Copy) ; ✓  Study Plan ; ✓  Two Recommendation Letters ; ✓  Passport Home Page ; ✓  Physical Examination Record for Foreigner ; ✓  Articles or Papers Written or Published ;  Examples of Art(6 color pictures)and Music(1 audio tape)Work(Only for the applicants applying for Fine Arts andMusic) ;  Other Attachments(List Needed) :   。 Note: All supporting documents uploaded must be clear scanning copies of the srcinal documents. Each Set of thecomplete materials should not exceed 20 pages . Please use DIN A4.Page 3 of 4Serial Number: 185B82DF0B Generated: 2018-03-30  ◆ I Hereby Declare That :: 1. All information and supporting documentation provided for this application are complete, true and correct ; 2. During my stay in China, I shall abide by the laws and decrees of the Chinese government, and will not participatein any activities in China which are deemed to be adverse to the social order of China and are inappropriate to thecapacity as a student ; 3. I will agree to the arrangements of my institution and specialty of study in China made by CSC,and will not applyfor any changes in these two fields without valid reasons ; 4. During my study in China, I shall abide the rules and regulations of the host university, and concentrate on mystudies and researches, and follow the teaching programs arranged by the university ; 5. I shall go through the procedures of the Annual Review of Chinese Government Scholarship Status as required ; 6. I shall return to my home country as soon as l complete my scheduled program in China, and will not extend mystay without valid reasons ; 7. If I am judged by the Chinese laws and decrees and the rules and regulations of the university as having violated anyof the above, I will not lodge any appeal against the decision of CSC on suspending, or withdrawing my scholarship,orother penalties 。 Page 4 of 4Serial Number: 185B82DF0B Generated: 2018-03-30
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