法蒂玛大学（M.D.）申请表
入 学 申 请 表 注册号： I. Application for 申请学位类型
□ MBA 工商管理硕士 □ MSc 医学硕士 □ M.Ed 教育学硕士 □ DBA 工商管理博士 □ EdD 教育学博士 □ M.D. 医学博士
Photo 照片 II. Personal Particulars 履 历
Name in Full
姓名 (英文) Surname first (姓) Given names （名）
Name in Chinese，if any
姓名（中文）
Sex
性别 □Male □Female / □男 □女
Date of Birth Place of Birth 出生日期 出生地
Nationality □Passport □ID No. 国籍 □护照 □身份证号：
Correspondence Address
通讯地址
Permanent Address
永久地址 Office Tel. No. Tel. No. 办公室电话 电 话 Fax
传真：
Email: Marital Status
婚姻状况 □Single □Married / □未婚 □已婚
III. Employment Information 工作经验 Date 日期 Name and Adress of To至 雇主名称及地址 Position Held 职位 From自 IV. Education & Academic Qualifications 学 历
N. B. Please enclose photocopies if relevant certificates and transcripts. Applicants will be required to produce original copies in due course.
法蒂玛大学（M.D.）申请表
注意：须附上有关证书之副本，正本备查。 Date Attended 在籍期间 From To 自 至 Name of Secondary School College and University 中学及大学院校 Field of Study 就读体系 Qualification Obtained (State Classification) 资格（注明等级） Date of Award 颁发日期
V. Personal Statement
Prepare a brief statement regarding
1. reasons you want to do graduate work in this field, 2. your specific interests and experience in this field, 3. your career plans.
请简述：1. 申请人就读原因，
2. 申请人在管理方面之兴趣及经验， 3. 个人事业之发展计划。
VII. Declaration of Application 个人承诺
a. l will certify that in De La Salle –Araneta University I observe the rules and regulations,never come
to the class lateor ditch school,finish the class,homework and paper on time,participate in each activity organized by the school and class.
我保证在学位班的学习过程中，严格遵守学校的各项规章制度，不迟到，不旷课，按时完成每门课后作业和论文，积极参加学校和班组织的各项活动。
b. I will follow the process of matriculation and paying ,finish the matriculation procedure and paying
the school fees,otherwise follow the school regulations.
我会按照学校的入学流程和交费流程，办好入学手续和学费的交纳手续，否则按学校规定处理。
c. I declare that all the particulars entered in this form are true and corrdct to the best if my knowledge
and understand that any false information entered will lead to disqualification of my application.
本人谨此宣誓，上述资料皆确实无误，本人明白上述资料，如有虚假，则将被取消申请资格。
d. I agree to pay the tuition fee of . I understand that all fees and tuition must be paid in full prior to graduation ,and a degree can not be awarded nor transcript released until all outstanding tuition and financial obligations have been cleared with Jose Rizal Preston University admissions office. 我同意交付学习费用 。我明白，只有全部学费都付清了，我才能够毕业，并获得学位和成绩单。
Signature of Applicant
签 名
Date
日 期
