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Application Form for Foreign Experts Work Permit

名(如护照所
示)
姓(如护照所示)
Surname First and
(as in passport) middle
names (as in
passport) 白色背景免冠照片
Passport photo with white
中文名(仅外 background
教华人)
其他曾用姓氏(外文) Chinese
Other surnames used name
(foreign
Chinese only)
□单身 Single
出生年月日 婚姻状况 □已婚 Married
别名或曾用名(英文)
Date of birth Marital □离异 Divorced
Other name used
(yyyy-mm-dd) status □丧偶 Widowed

□HSK1
最高学位
□HSK2
国籍 Highest 汉语水平
□HSK3
Nationality educational Chinese proficiency
□None
qualification

是否持有境外职业资格
□男 Male 护照号码 证书
□女 Female Have you ever obtained □是 Yes
Passport
any professional □否 No
number
qualification certificate
abroad?
国外联系电话 &
职业资格证书名称和编号
邮箱
Name and number of
professional qualification Home country
tel. Number and
certificate
e-mail)

列出所有曾授予你护照的国家
工作年限
List all countries that ever years
Related working experience
issued you a passport

公认职业成就名
公认职业成就 □是 Yes 称 Title of the
Recognized professional recognized
□否 No
achievement professional
achievement
是否毕于世界知名大学?
学校名称
Did you graduated from a □是 Yes
Name of the
world renowned □否 No
university
university
是否持有中国职业资格证 □是 Yes 职业资格证名称 □ 外教飞行员 职业资格证书号码
书(准入类) □否 No (准入类) Foreign aircraft pilot Number of
Have you ever obtained Title of professional
any chinese professional professional □外国医师 qualification
qualification certificate? qualification Foreign doctor of certificates
(for industry access) certificate (for medicine obtained (for
industry access) industry access)
是否曾在世界 500 强企业、知名金融机
在上述单位担任最高职务及公司名称
构或律师事务所等任职 □是 Yes Highest position you have ever held in
Do you have any experience in world □否 No aforementioned organizations and full
top 500 companies, well-known name of the companies
financial institutions or law firms?
是否有专利等知识产权 □是 Yes 专利等知识产权名称
Do you own a patent and other Full name of the patent and other
□否 No
intellectual property rights intellectual property rights
已连续在华工作年限 在中国工作电话 Telephone
Total number of years working in china number in china
申请 z 签证的国家
In which country will you apply for your employment visa?
Please precise the embassy or consulate

紧急联系人 Emergency
contact name 紧急联系人联系方式(电话 &
邮箱 & 地址)
关系 Telephone & email & address
of emergency contact
Relationship to
applicant
列出曾工作的单位(近 10 年内)
list all employers you have worked for over last ten years
起止时间
名称 职务 工作任务 工作所在国家
Time(yyyy-mm
Name Position Job description Location
to yyyy-mm)

列出曾就读的高等教育学校(含职业教育学校,如无高等教育经历,请填写最高学历)
list all higher educational institutions you have attented (including vocational institutions)
就读时间
名称 专业 取得证书
Time of attendance(yyyy-
Name Major Qualification
mm to yyyy-mm)

随行家属情况
Accompanying family members
姓(如护照所
姓名 Name 示)
Surname (as in
passport)

名(如护照所
示)
First and
middle names
(as in passport)
与申请人关系
Relationship to applicant

国籍
Nationality

护照号码
Passport number
联系电话
Emergency contact
telephone number
邮箱
E-mail address
您是否由于犯有任何罪行而曾经被逮捕或被判有罪,即使后来得到了赦免或收回等其他类似
措施? □是 Yes
Have you ever been arrested or convicted for any offense or crime, even though subject of □否 No
a pardon, annulment, amnesty or other similar legal action?
您是否曾感染过对公共健康有影响的传染病或患过构成危险体制病变或精神病?
□是 Yes
Have you ever been afflicted with a communicable disease of public health significance or
□否 No
a dangerous physical or mental disorder?
您是否曾违反中国法律,被中国政府递解出境? □是 Yes
Have you ever violated the laws of china, and been deported from china? □否 No
本申请表上所做之回答均属事实且详尽,所附材料真实、有效,若所提交的内容被发现不实或不详,本人愿意
承担法律责任。
This is to certify that all the answers to this application form and all relevant attachments to it are true,
genuine and complete. If the information is found to be untrue, forged or incomplete, I am aware that I need to
bear corresponding legal responsibilities.

申请人或委托人名 日期
Signature of applicant Date (yyyy-mm-dd)

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