Student ID (Roll No.)
Surname(s)
First Name(s)
Gender
Nationality
City of Birth
Passport No.
Passport Expiry Date
Room No.
Date of Birth（DD/MM/YYYY）
Marital Status
Religion
Official Language
Educational Background
Working Experiences
Which city were you working in before MPH program?
Which city were you living in before MPH program?
Is your last job and position retained?
Is your salary suspended?
Will you get promotion after the complement of this program?
Mobile Phone No. at Home
Mobile Phone No. of China
E-mail
Home Address
Relation of the person to be Contacted in Emergency (Person 1)
Name of the person to be Contacted in Emergency (Person 1)
His/Her Employer Name &Position (Person 1)
His/Her Address (Person 1)
His/Her Tel (Person 1)
His/Her E-mail (Person 1)
Relation of the person to be Contacted in Emergency (Person 2)
Name of the person to be Contacted in Emergency (Person 2)
His/Her Employer Name &Position (Person 2)
His/Her Address (Person 2)
His/Her Tel (Person 2)
His/Her E-mail (Person 2)
Your Hobbies
Remarks