Chinese Scholarship Form

1. APPLICATION FORM FOR CHINESE GOVERNMENT SCHOLARSHIP
Personal Data:
Agency No. Agency Name
10010 BEIJING UNIVERSITY OF CHEMICAL TECHNOLOGY
Family Name Given Name
PAKISTANI KAMRAN TAHIR
Photo
Chinese Name Gender
Male
Date of Birth Marital Status
1982-09-01 Married
Nationality Native Language Passport No.
Pakistan Urdu BA7122901
Country of Birth City of Birth Religion
PAKISTAN BANNU ISLAM
Permanent Contact Tel Permanent Contact Fax Permanent Contact E-mail
0966750359 kamran.gu@yahoo.com
Permanent Contact Address
village nar asperlai p/o nar muzzaffar distt; Lakki marwat kpk pakistan
Present Contact Tel Present Contact Fax Present Contact E-mail
0966750359 kamran.gu@yahoo.com
Present Contact Address
village nar asperlai p/o nar muzzaffar distt; Lakki marwat kpk pakistan
Education Background and Employment Record:
Highest Diploma
Institution
gomal university
Years Attended Fields of Study
From 2003-09-02 To 2005-08-05 organic chemistry
Certificates Obtained or to Obtain
obtained
Other Certificate I
Institution
gomal university
Years Attended Fields of Study
From 2001-09-03 To 2003-07-02 chemistry ,botany ,statistics
Certificates Obtained or to Obtain
obtained
_____________________________________________________________________________________________________________________
Serial Number: 183155 Page 1 of 3 Generated: 9 Feb 2013

2. Other Certificate II
Institution
BISE BANNU
Years Attended Fields of Study
From 1999-09-02 To 2001-07-03 medical group
Certificates Obtained or to Obtain
obtained
Current Employment
Employer
gomal university D.I.KHAN
Time Engaged Work Engaged
From 2008-12-04 To 2013-02-08 teaching
Posts Held
lecturer
Language Proficiency and Proposed Study in China:
Chinese Proficiency Level of HSK test or other certificates
None
English Proficiency I can be taught in English Other Language
Excellent yes urdu,pashto
Apply for Disciplines
Doctor's Degree Natural Science
Majors
Organic Chemistry
Preferences of Institution I
BEIJING UNIVERSITY OF CHEMICAL TECHNOLOGY
Preferences of Institution II
Preferences of Institution III
Duration of the Major Study
From 2013-09-01 To 2016-07-15
Do You Need Elementary Chinese Study prior to the Major Study
no
Duration of Your Elementary Chinese Study (not included in the length of the major study)
Have you ever Studied or Worked in China
no
Institution or Employer Time(from/to)
Contact in China and Family Members:
Guarantor's Name Tel
professor Li Baoshan +861064445611
E-mail Fax
bsli@mail.buct.edu.cn
Address
Deptt of chemistry, beijing university of chemical technology
_____________________________________________________________________________________________________________________
Serial Number: 183155 Page 2 of 3 Generated: 9 Feb 2013

3. Spouse's Name
Sadia Nazir
Age Employment
26 lecturer
Father's Name
Tahir shah
Age Employment
60 nil
Mother's Name
Mir ama jan
Age Employment
54 nil
◆ Supporting Documentation Attached(Please Indicate with 'X' in the Bracket.):
□ Two Application Forms.
□ Two Letters of Recommendation.
□ Admission Letter or Admission Notice of Chinese Universities.
□ Transcripts of the Most Advanced Studies(Notarized Photocopy).
□ Diploma of the Most Advanced Studies(Notarized Photocopy):
Bachelor's□ Master's□ Doctor's□ Others□
□ Foreigner Physical Examination Form(Photocopy).
□ Study Plan in China.
□ Articles or Papers Written or Published.
□ Examples of Art(6 color pictures)and Music(1 audio tape)Work(Only for the applicants applying for Fine Arts and Music).
□ Other Attachments(List Needed)：_______________________________________________________________
Note:Each Set of the complete materials should not exceed 20 pages．Please use DIN A4.
Whether the candidates are accepted or not,all the application materials will not be returned.
◆ I Hereby Declare That:
1. All information and supporting documentation provided for this application are complete, true and correct.
2. During my stay in China,I shall abide by the laws and decrees of the Chinese government,and will not participate in any activities
in China which are deemed to be adverse to the social order of China and are inappropriate to the capacity as a student.
3. I will agree to the arrangements of my institution and specialty of study in China made by CSC,and will not apply for any changes
in these two fields without valid reasons.
4. During my study in China,I shall abide the rules and regulations of the host university,and concentrate on my studies and researches,
and follow the teaching programs arranged by the university.
5. I shall go through the procedures of the Annual Review of Chinese Govemment Scholarship Status as required.
6. I shall return to my home country as soon as l complete my scheduled program in China,and will not extend my stay without valid
reasons.
7. If I am judged by the Chinese laws and decrees and the rules and regulations of the university as having violated any of the above,
I will not lodge any appeal against the decision of CSC on suspending,or withdrawing my scholarship,or other penalties.
Signature of the Applicant:_____________________Date:_________
(The application is invalid without the applicant's signature)
_____________________________________________________________________________________________________________________
Serial Number: 183155 Page 3 of 3 Generated: 9 Feb 2013