哈佛燕京访问学者项目申请表格英文

VisitingScholarsProgram HARVARD-YENCHINGINSTITUTE

(-)

Returnto: DeadlineforApplication:June15,

ProgramOffice

Harvard-YenchingInstitute Phone: 617-495-0702

VansergHall,Suite20 Fax: 617-496-7206

25FrancisAvenue Email:

Cambridge,MA02138

USA

(Pleasetypeorwriteinblackink)

PARTONE(tobecompletedbyfacultymemberapplying)

FamilyName__________________________GivenName_________________________________________

漢字____________________________

Age___________ Gender(pleasecircle):Male/Female

2. PlaceofBirth:City___________Country________________DateofBirth_______________________________

3. Citizenship(nationfromwhichpassportisobtained)_____________________________________________________

4. Presenttitleasfacultymember_____________________________________________________________________

5. University: Department:

6. Officeaddress____________________________________________________________________________________

H

O

7.Telephone

8. Fax:

9. Email:

10. BestMailingAddress:____________________________________________________________________________

_______________________________________________________________________________________________

11.Colleges&UniversitiesAttended Principalsubject Datesofstudy Degree&yearawarded

____________________________ _______________________________ __________________

____________________________ _______________________________ __________________

____________________________ _______________________________ __________________

____________________________ __________________________________________________

12.Names,addresses,phone/faxnumbersandemailaddressesofindividualsfromwhomyouarerequestinglettersof recommendation.Three(3)arerequired,oneofwhichmustbefromyouradviserorthepersonmostfamiliarwith

yourscholarlywork.Pleasesendthethreelettersofrecommendationtogetherwithyourapplicationform.

.

Names Phone/faxnumbers addresses Email

________________________________ _________________________________ __________________

______________________________ _____________________________________________________

_______________________________ _________________________________ __________________

13.ListanyFacultymember(s)atHarvardUniversityand/oranyothermajoruniversityintheUnitedStateswithwhomyouwishtoconsultduringthestayofthefellowship.

Name Department Field

__________________ ___________________________ ___________________________

__________________ ___________________________ ___________________________

Listtheabovefacultymember’stwopublications(withdetailedcitationinformation)thatarehighlyrelevanttoyourresearch.

1)_________________________________________________________________________________

2)_________________________________________________________________________________

14. Previousfellowships,scholarships,grants,andotherhonors________________________________________________

_______________________________________________________________________________________________

15.Areyouapplyingforfundingfromanyotherorganizations?______________________________________________

16.HaveyoueverappliedforaHarvard-YenchingScholarshipbefore?________Ifso,when?______________________

17.TitleofProposedResearch:

________________________________________________________________________________________

________________________________________________________________________________________

18. Listallpositions,academicorother,inchronologicalorder,withdates,includingthedatefromwhichyouhave heldyourpresentfacultyposition:_____________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

19.Publicationswhereapplicable.PleaselisttitlesintheoriginallanguageaswellasEnglish.Attachaseparatebibliography

ifspacehereisinsufficient___________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

20. Foreigntravel:Ifyouhavevisitedorlivedinanycountriesotherthantheoneinwhichyouarenowemployed,

pleasegiveplaces,dates,andpurposes:_________________________________________________________________

_______________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

21. Indicateyourknowledgeofthelanguageslistedbelowandanyothers.Ifoneisyourownlanguage,writenative:elsewhereslightly,fairlywell,orfluently.

CHINESE: Speak__________Read_______________

JAPANESE: Speak__________Read_______________

ENGLISH: Speak____________Read_______________

KOREAN: Speak__________Read_______________

THAI: Speak____________Read________________

VIETNAMESE:Speak__________Read________________

OTHER(______):Speak______Read________________

21. Whatisthesubjectofyourresearchplan?Scholarshipsareintendedfororiginal,publishableresearch.(Itisnot

necessarythattheresearchbecompletedduringtheyearatHarvard.)ThescholarshipisNOTintendedforthe

compilationoftextbooksorthewritingofgeneralsurveysofyourfield.GiveadescriptioninEnglishinabout3-5pages,

explainingyourresearchplansatHarvardUniversityor/andanothermajoruniversity.Pleaseinserttheextrapage(s)inthisapplicationformifnecessary.

22. AGREEMENT:IfIamawardedaHarvard-YenchingInstituteVisitingScholarsFellowshipatHarvard

University,IwillreturntomydutiesatmyemployinguniversityinAsiaattheconclusionoftheFellowship,

oratsuchearliertimeasmyhomeuniversityand/ortheHarvard-YenchingInstitutemayrequire.IfIam

awardedafellowship,IwillapplyforaJ-1(scholar)visatoentertheUnitedStates.

Signed

Date

PARTTWO: INSTITUTIONALAPPROVAL(tobesignedbythePresident,Vice-Chancellor,Rector,Deanof

Faculty,orotherappropriateadministrativeofficeroftheapplicant'ssponsoringuniversityinAsia.)

Applicationisincompletewithoutapproval.

TO: VisitingScholarsProgramOffice

HARVARD-YENCHINGINSTITUTE

VansergHall,Suite20

25FrancisAvenue

Cambridge