辽宁中医药大学在线报名系统
*为必填项。
For the accuracy of your Admission Notice and Visa Application Form (JW202),please do ensure the infomation above you filled is accordant with your application form.

* 1. 邮箱 Email
 
  2. 中文姓名 (Chinese Name):
 
* 3. 外文姓 Family Name(Name on Passport):
 
* 4. 外文名 Given Name(Name on Passport):
 
* 5. 出生年月 Date of Birth:
 
* 6. 国籍 Nationality:
 
* 7. 性别 Gender:
   
 
  8. 婚否 Marital Status:
   
 
* 9. 出生地点 Place of Birth:
 
* 10. 护照号码 Passport NO.:
 
* 11. 护照有效期 Passport Validity:
 
  12. 职业 Occupation:
 
  13. 宗教 Religion:
 
* 14. 通信地址 Correspondence Address (The length should be less than 120 characters):
 
* 15. 家庭电话 Telephone:
 
* 16. 移动电话 Mobile Phone:
 
  17. 联系传真 Fax:
 
* 18. 母语 Mother Language:
 
* 19. 最后学历 Highest Academic Qualification:
 
  20. 工作单位 Employer:
 
* 21. 申请类别 Application category:
 
* 22. 专业 Course:
 
* 23. 申请学习期限起 Duration of Study in XMU(from):
 
* 24. 申请学习期限止 Duration of Study in XMU(to):
 
  25. 汉语水平 Chinese Language Proficiency:
 
  26. 在华联系人 Contact person in case of emergency(name):
 
  27. 联系人电话 Contact person in case of emergency(tel):
 
  28. 联系人手机 Contact person in case of emergency(mobile photo):
 
  29. 联系人地址 Contact person in case of emergency(address) (The length should be less than 120 characters):
 
 
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