青年拔尖人才支持计划申请表.doc

西安交通大学“青年拔尖人才支持计划”申报表Application Form for the “Young Talent Support Plan”of Xian Jiaotong University申报人姓名： Applicant Name专业领域： Area of Expertise 所属学院： School or Department 填报日期： 年 月 日 Date of Completion Y M D（本表根据申请人建议做了修改，之前公布的表格均有效。特别提醒，每项内容都用中英文两种语言对照填写,非华裔应聘人可只填英文。） (This form is the latest version. Former ones are still valid. Please fill out all fields in both Chinese and English; non-Chinese applicant can fill out in English only. )一、个人基本信息 Basic Information姓名Name性别Gender出生年月Date of Birth专业领域及方向Area of Expertise and Research Interest 出生地Place of Birth现工作单位Current Employer 专业技术职务Professional Position最后学位及授学位单位Highest Degree Awarded and School of Graduation二、教育经历（从大学填起，按时间顺序正序填写） Educational Experience (Please present in chronological order, starting from the bachelor degree)起止年月Start-Due Date院校University专业Major学位Degree三、工作经历（请按时间顺序正序填写，兼职请注明） Work Experience (Please present inchronologicalorder and indicate the part-time positions)起止年月Start-Due Date工作单位Employer职务/职称Position四、业绩综述（1000字以内） Summary of Academic Performance (Within 1000 words)5、 代表性成果 Representative Achievement1、代表性论文（10篇以内）Representative Publications (Within 10)论文名称；发表刊物名称；期号、起止页码；作者排序（按顺序写出全部作者，通讯作者标注*号）Title;Journal Name;Issue and Page No.; Authors (Please present all authors and mark the corresponding author with* )论文影响力（期刊影响因子，被引用情况，被评价情况等）Publication Impact (Journal IF, citation, evaluation and etc.) 2、代表性著作（3部以内）Representative Works (Within 3)著作名称Book Title出版单位Publisher 作者Author出版年度Publication Year3、专利（已授权，10项以内）Patents (Granted patents, within 10)专利号Patent No.专利名称Patent Name类别Type授权国家Country of Granting专利所有者Owner4、 获奖（5项以内） Awards (Within 5)获奖或荣誉名称Name of Award or Honor颁发机构Issued by获奖等级Award Level获奖年份Year排名Ranking主要合作者Main Partner 5、主持（参与）的科研项目（10项以内）Projects (leading or participating) (Within 10)起止时间Start-Due Date项目名称Name经费来源及额度Source and Total Amount of Funding申报人的具体职位和任务Position and Responsibilities of the Applicant6、学术组织任职、重要学术报告（10项以内）Positions in Academic Organizations; Invited Talks in Key Academic Conferences (Within 10)六、提供推荐信的专家简介 Profile of Referees推荐人1：Referee1 推荐人2：Referee 2七、可供比对的3-5名同龄学者名单 List of 3-5 Comparable Peers姓 名Name工作单位EmployerResearcherID申报人ResearcherIDApplicants ResearcherID（申报人可在/ 网站建立自己所有ISI论文信息库，公开自己的ResearcherID免费网页） (Please register at / and get your ResearcherID for free)八、工作设想（未来研究计划、预期贡献等） Work Plan (Including research plan, expected contribution and etc.)希望学校提供的设备费和科研启动费（金额、测算依据）Expected Start-Up Funding for Equipment and Research (Please specify the amount and basis of the budget) 本人自愿申报西安交通大学“青年拔尖人才支持计划”，本人承诺所填全部信息均真实有效。 I willingly apply for the “Young Talent Support Plan”of Xian Jiaotong University and declare that the above information is true and correct to the best of my knowledge.申报人签名（电子签名）: Signature of the Applicant (e-signature) 年月日 Y M D附件材料建议内容Recommended List for Appendix（除身份证明外，其他由申报人自行决定是否提供）(Identification must be provided. Other supporting materials are optional.)（1） 身份证明（本校教师不用提供）；Identification (No need for current employees)（2） 与学位、任职相关的证明（本校教师不用提供）；Degree Certificate and Employment Proof (No need for current employees)（3） 主要成果（代表性论著、专利、奖励等）证明材料，请提供1-3篇重要创新性论文的全文及其刊载杂志封面、目录复印件； Supporting Documents for Achievements (Representative works、papers、patents、awards and etc.) Please provide copies of 1-3 important publications with full texts, journal covers and catalogues（4） 主持（参与）过的主要项目证明材料；Proofs for Projects Involved (either leading or participating) （5） 国际国内学术组织任职、学术会议所做重要报告的证明材料；Proofs for Positions in International and Domesticate Academic Organizations and for Invited Talks in Academic Conferences（6） 3-5封海外同行专家的推荐信；3-5 Recommendation Letters from Experts （7） 其他需要提交的材料。Other Supporting Materials请注意：以上材料可为打印件，也可为电子版。打印时与申报表分开装订，尽量双面打印。Note: All materials can be hard or electronic copy. Appendix materials and Application Form should be bound separately. Duplex printing is preferred.申报人其他个人信息表Other Personal Information of the Applicant（非公开信息）(Non-Public)姓名Name国籍Nationality 有效身份证件名称Name of Valid Identification有效身份证件号码Number of Valid Identifi