签证到期日Expirydate of visa ?
国家或地区、组织 Recommendedby which department,agency or organization?
学历/学位 Education/Academic Degree?
手机号码 Mobile phone number?
固定联系人地址 Address of fixed contact person?
紧急联系人姓名 Name of emergency contact person:
紧急联系人电话 Phone number of emergency contact person:
紧急联系人地址 Address of emergency contact person:
紧急联系人传真 Fax of emergency contact person:
紧急联系人电邮 E-mail of emergency contact person:
饮食禁忌 Dietary restriction?
教育背景及专业职称 Education background Professional title?
| | Datesof your degrees | Educational degrees | Degree-conferring entity |
| 1 | ____________ | ____________ | ____________ |
| 2 | ____________ | ____________ | ____________ |
| 3 | ____________ | ____________ | ____________ |