科研实习 - 中国科学技术大学国际学院.doc

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 邮箱 拟录取类别 □本科生(Undergraduate) Email Level of Study □硕士生(Master) □博士生(PhD) 拟录取专业 拟录取系别 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。如有往来邮件请附 后。 ）（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.