* Name:

* Name in Chinese:

* Nationality:

* Gender:

* Date of Birth:

* Organization:

*Address(in Tian Jin):

* Tel:

Mb:

Fax:

E-Mai:

* Passport No.:

* Date of Entry:

* Type of Visa:

Guarantor:

Add of Guarantor:

Tel of Guarantor:

* New student:

Type of Class:

Group   Individual

Period of study:

From to sample：1983-03-12