文档介绍：UNIVERSITY OF SCIENCES AND TECHNOLOGY OF LILLE
Academic and Student Life Department
59655 VILLENEUVE D ' ASCQ CEDEX
USTL
FILE N。：
09
(for administration only)
INTERNET CONNECTION N° : 2009
APPLICATION FORM FOR ADMISSION IN
LICENCE-MASTER-DOCTORATE
FOR THE ACADEMIC YEAR 2009-2010
DEADLINE: 30 AVRIL 2009*
(THIS FILE IS NOT A REGISTRATION FORM AT THE UNIVERSITY)
HOME INSTITUTION : Harbin In stitute of Techno logy
SURNAME (of birth): HU NAME : ZHEPENG
Gen der:匚 Male Female
Date of birth (dd/mm/yyyy): 17/12/1989 Place of birth: DALIAN CITY
LIAONING PROVINCE
NATIONALITY:
th
ADDRESS: 9 STUDENTS APARTMENT, HARBIN INSTITUTE OF TECHNOLOGY, HARBIN, HEILONGJIANG PROVINCE, CHINA Postcode: 150000
TEL: ********** E-mail:******@
Which degree programme would you like to study
(Only one choice possible)
DECISION DE LA COMMISSION
Commissaire:
Date :
Please in dicate the complete n ame of programme (please refer to page 6)
Code
Lice nce1
Lice nce2
Lice nce3. Organisation, Management, Control
Master1
Master2
Doctorate
Accord
Refus Motif :
Convoqu pour test Autre propositi on Sig nature :
…
IUP LOGC
CERTIFIED EDUCATION (PAST and PRESENT)
Academic Year
Name of Diploma/degree studied (please precise the in terrupti ons)
School/City
Diploma obtained (disti nctions)
2009/2010
School of Huma nity and Social scie nces
Harbin In stitute of Tech no logy
2008/2009
School of Huma nity and Social scie nces
Harbin In stitute of Tech no logy
2007/2008
High School Diploma
DALIAN high school
2006/2007
Senior High School
DALIAN high school
Excelle nt League
2005/2006
Senior High School
DALIAN high school
Excelle nt League
2004/2005
Junior High School
DALIAN YUWEN SCHOOL
Excelle nt League
2003/2004
Junior High School
DALIAN YUWEN SCHOOL
2002/2003
Junior High School
DALIAN YUWEN SCHOOL
1999/2000
Junior High School
MIDDLE SCHOOL HARBIN
Year: